WASHINGTON – In an informal survey held during a session of the World Health Care Congress April 14-16 in Washington, D.C., two-thirds of those polled said in five years they expect 25 percent of healthcare services to be reimbursed based on performance.
The Sixth Annual World Health Care Congress brought together CEOs and executives from all segments of the healthcare industry. In a panel session focused on payment issues, Peter Lee, executive director of national health policy of the Pacific Business Group on Health, said pay for performance, or P4P, is a good thing, but the current relatively meager efforts to base pay on value won't go too far in improving the ailing system.
"It's like putting a tiny little bit of lipstick on a very ugly pig," he said.
Andrew Webber, president and CEO of the National Business Coalition on Health, said larger employers are focused on improving the level of care while containing costs. "I think we need to move in the direction of rewarding prevention, primary care, chronic care management, and do that in a way that all stakeholders can agree upon," he said.
Jon Perlin, MD, president of clinical services and chief medical officer for the Hospital Corporation of America, said value-based care is a good way to bring accountability to providers and encourage coordination across different care settings. “The new bottom line is performance," he said.
Perlin promoted remote monitoring of chronic care patients, the advancement of health IT and changing incentives to bundle episodes of care. With focused effort, HCA has made significant headway in reducing readmissions among its hospitals, he said.
Robert Galvin, MD, director of global healthcare at General Electric and a founder of the Center for Payment Reform, said the private sector has made headway with P4P, and now the Centers for Medicare & Medicaid Services and Congress have begun to implement it. He is disappointed, however, in what he called "a striking lack of input" on the Hill from the private sector.
"We think the details really matter," he said.
Galvin warned of unintended consequences in bundling payments. If lawmakers are not careful, he said, large healthcare organizations could use their market share to set prices.
Galvin said he is encouraged by efforts made by employers – who cover more than 170 million Americans – to push reform. "With the right strategy, we can't solve, but we can catalyze change," he said.
