Survey: Health reimbursement system should be overhauled

Health policy experts want to replace the current method of negotiating healthcare payments with individual doctors and hospitals, preferring a government-set rate or an all-payer system of jointly negotiating rates, according to a recent Commonwealth Fund survey.


Insurers currently engage in a complex and continuous process of negotiations with healthcare providers to establish reimbursement rates for services, which increases their administrative expenses and leads to wide variation in prices, reports MedPage Today.

Opinion leaders also voiced broad support for creating a standard method of rewarding quality and efficiency across private insurers and public payers. More than seven of 10 said they felt it was important for all payers to use the same basic method of rewarding providers, which may be an effective way of improving patient outcomes, reducing wasteful administrative expenses and lowering costs, according to Healthwatch.

"Experts agree that if private payers and public programs could come together and agree to pay the same way, and the same amount, we can improve the efficiency of our healthcare system, eliminate administrative waste, and create better experiences for patients," said Commonwealth Fund President Karen Davis in a statment.

In addition, 73 percent of respondents support salaried physicians with rewards for both quality and resource use, and 53 percent of leaders support using tiered networks, according to Becker’s Hospital Review. Survey respondents also supported several other changes to the reimbursement system, including value-­based benefit design and reference pricing.

To learn more:
- check out the MedPage Today story
- read the Becker’s Hospital Review story
- see the Healthwatch article
- read the Commonwealth Fund study