TUCSON, Ariz., Jan. 30, 2015 /PRNewswire-USNewswire/ -- The White House has announced its intention to set an aggressive timeline to move from "volume to value" in Medicare. This means replacing fee for service—payment for work—with an "alternate payment methodology."
The government plans to evaluate whether patients are healthier, "among other measures," according to the Washington Post of Jan 26. By the end of 2018, "HHS hopes to link 50% of payments to these arrangements," stated HHS Secretary Sylvia Mathews Burwell in a press conference.
Officials from the American Medical Association the American Hospital Association, several nonprofit healthcare systems, and large insurers such as UnitedHealth Group, Anthem and Aetna were at the press conference announcing the new goals. AMA President Robert Wah, M.D., said: "Today's announcement by [HHS] aligns with the American Medical Association's commitment to work toward innovative care delivery reform."
"While everybody else gets paid for performing a certain task or working a certain number of hours, doctors are to be paid—or not paid—based on health outcomes or achievement of as-yet-undefined quality metrics," stated AAPS executive director Jane M. Orient, M.D. "Health outcomes are largely outside the doctor's control. Complicated patients or those who choose an unhealthy lifestyle will be money losers for doctors."
The way to financial survival under "alternative payment" is to treat healthy patients according to protocols rather than what is best for the patient. "Value" means value to the system, not to individual patients, she noted.
Medicare has a rigid, complex system of price controls. "Doctors are paid by the AMA procedure code," Orient explained. "This has no relation to value to the patient or cost to the doctor. The right alternative is a free-market price, and a method that allows the patient, not just the system, to benefit from economizing."
The Association of American Physicians and Surgeons (AAPS) is a national organization representing physicians in all specialties, founded in 1943 to preserve private medicine and the patient-physician relationship.
SOURCE Association of American Physicians and Surgeons (AAPS)