Condition based payment: improving care of chronic illness

[...]it aligns providers and patients. Summary points Fee-for-condition better aligns the provider and patient than do today's payment mechanisms It rewards providers for innovations that improve results and rewards patients for seeking the best care at the best price By linking price and outco...

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Bibliographic Details
Published inBMJ Vol. 330; no. 7492; pp. 654 - 657
Main Authors DiPiero, Albert, Sanders, David G
Format Journal Article
LanguageEnglish
Published London British Medical Journal Publishing Group 19.03.2005
British Medical Association
BMJ Publishing Group LTD
BMJ Publishing Group
BMJ Publishing Group Ltd
EditionInternational edition
Subjects
Biological and medical sciences
Chronic Disease - economics
Chronic Disease - therapy
Chronic diseases
Chronic illnesses
Compensation
Cost control
Diabetes
Education And Debate
Fee for service health care
Fee-for-Service Plans - economics
Fee-for-Service Plans - organization & administration
Fees
Fees & charges
General aspects
Health care access
Health Care Costs
Health care payments
Health outcomes
Humans
Innovations
Market prices
Medical research
Medical sciences
Methods
Mortality
Patients
Pay for performance
Payment methods
Payment systems
Physicians
Quality of Health Care - economics
Reimbursement Mechanisms
Type 2 diabetes mellitus
United Kingdom
UK
Medicine
Chronic
Payment
Health economy
Public health
Care
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Summary:[...]it aligns providers and patients. Summary points Fee-for-condition better aligns the provider and patient than do today's payment mechanisms It rewards providers for innovations that improve results and rewards patients for seeking the best care at the best price By linking price and outcomes, fee-for-condition achieves greater transparency of quality and cost than do current payment mechanisms Chronic care practitioners can effectively use their advantage in performance to lead the way to a more rational payment system All proposed changes in provider compensation risk backlash from providers and patients, as we learned from the American experiment with managed care.
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PMID:15774999
Correspondence to: A DiPiero, Division of General Internal Medicine and Geriatrics, L475, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA
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Correspondence to: A DiPiero, Division of General Internal Medicine and Geriatrics, L475, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA dipieroa@ohsu.edu
Contributors and sources: AD is a physician and faculty member at Oregon Health and Science University, where he helped establish a diabetes chronic care model practice. DS is a physician and former chief executive officer of two healthcare technology companies. Together the authors have a decade of experience in healthcare business, with previous clients including insurers, hospitals, pharmaceutical companies, and provider organisations. They currently advise insurers, hospitals, providers, and government organisations on provider payment models and incentives.
Competing interests: AD works in a diabetes chronic care practice at Oregon Health & Science University. AD and DS are uncompensated co-chairs of HealthOregon, a public service organisation dedicated to improving the quality and affordability of health care.
Aspects of this manuscript have been presented orally to the Oregon Health Policy Commission and Legacy Health Systems Internal Medicine Grand Rounds. The presentations are posted at www.oregon.gov/DAS/OHPPR/HPC/HPCMinutes.shtml and at www.healthoregon.net
ISSN:0959-8138
0959-8146
1468-5833
1756-1833
DOI:10.1136/bmj.330.7492.654