Let me ask you some questions. How many of you have had so many medical bills from one hospital visit; that you never knew who, or how much you were paying? How many of you have received a bill, months after you thought you had already paid everything off for that same hospital visit? How many of you, have found on your credit report a collection account from a care provider collecting on a bill that you thought you had paid for that hospital stay? The Bundled Care Payment Initiative solves all of these questions; I will show you how later in this rebuttal.
How many of you feel that the Dr. and hospitals should be paid based on the quality of service provided not based on the quantity of service? This means that they are paid based on how well they do at fixing your problems, rather than by the amount of problems they say you have and give you medications for. Let me give you an example. I recently made an acquaintance by the name of Kelly. Kelly was diagnosed a few years back with high cholesterol. The Dr. said take this pill, Kelly said, " Is there anything else I can do besides take a pill?" The Dr. told him no he needed to take the pill. Kelly went away determined to prove the Dr. wrong. Kelly changed his diet and began to exercise. After six months Kelly returned to the Dr. The Dr. told him his high cholesterol was back to normal, the pill must have worked. Kelly told the Dr. he never took the pill he just changed his habits. This is an example of quality of care that I believe we are currently receiving. Instead of helping us to fix and prevent the problem we are given drugs so the problem does not get worse. The Bundled Care Payment Initiative also helps with this.
Last class it was quoted that "we cannot sustain the current fee-for-service system." If we cannot sustain the current fee-for-service option why would we opt to stay with this program rather than changing to a program that is better for us all?
"The Current fee-for-service payments drive up health care costs and reward quantity over quality, and they encourage wasteful use, especially of high-cost items and services. They do nothing to align financial incentives between different providers. As a result, patients receive care that they do not need and may not want, and health care providers may not be on the same page about what type of care the patient should receive." The current fee-for-service payment incentivizes healthcare providers to over-diagnose and over-treat patients.
The Center forAmerican Progress is a DC-based liberal think tank created and led by President and Chief Executive Officer John D. Podesta, the head of Barack Obama's presidential transition team talks about Bundled Care Payment Initiative options.
Bundled Care Payment Initiative "Instead of paying separately for each individual service, the insurer would pay a set amount for the inpatient hospital services and physician services, as well as the post-acute care services. Because the insurer would pay a fixed amount to health care providers to treat the patient following his fall, all providers would have an incentive to coordinate care that the patient actually needs. And because the providers’ reimbursement amounts would depend in part on meeting quality and patient experience measures, the entire team of providers would be focused on improving quality." There are the answers to the first group of questions. Instead of you having to juggle all of the bills that are sent to you, you only have to juggle one. No bills would be missed, no collection accounts on your credit, and you will know whether or not you paid that one bill. To answer the other question about paying for quality vs. quantity, this program allows for related readmissions for 30 days after hospital discharge are included in the bundled payment amount. This would require the Dr. to make sure they are diagnosing correctly and resolving the issues the first time rather than a patient having to pay for every visit back to the hospital.
In the last class it was stressed that the Bundled Care Payment Initiative has been very unsuccessful. It was stated that only 18 sites are currently participating. It is true there are only 18 sites currently participating, but what we need to know that phase 1 of this system only began in 2013. There is a lot that is involved in changing billing in procedures in the health care system, just over a year is hardly enough time to criticize the amount of participants.
The Bundled Care Payment Initiative is a good program to solve today’s problems. It may not be perfect but it is a start at benefitting every patient rather than benefitting the hospitals and doctors. This program will cut costs by eliminating over-diagnosing by doctors. Patients will not be turned away from being re-admitted as was stated. Each patient will receive high levels of care that will eliminate many re-admissions. Re-admissions will be eliminated because all doctors involved coordinated the care that was given the first time and a correct diagnosis was given.
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