Christopher F. Koller
President of the
Milbank Memorial Fund
Payment Reform: Innovation, Evaluation, and Perspiration
My e-mail inbox is full of innovations—solicitations for health care meetings, most offering “unique opportunities” to hear from “national leaders,” all of whom are busy innovating.
Much of the conference fodder focuses on payment reform. Thanks largely to the Affordable Care Act (ACA), the federal government—of all places—is an agent of innovation, paying for new services in new ways through initiatives, programs, and payment mechanisms such as episodes of care, accountable care organizations, health homes, and comprehensive primary care. The commercial insurance industry is following suit, and we are awash in a veritable tsunami of innovations. Value-Based Payments and Alternative Payment Mechanisms—involving population-based payments, risk-sharing arrangements, bundled payments and pay for performance—are swamping the industry.
Innovation is not the same as improvement, however. Payment innovations may create employment opportunities for consultants, but do they work?