Mismatched payment incentives are partly to blame for Americans' excessive wait times for needed healthcare, according to an article from The Columbus Dispatch.
"In our market-based system, patients can get lucrative procedures rapidly, even when there is no urgent medical need: Need a new knee, or an MRI, or a Botox injection? You'll probably be on the schedule within days," noted the article, which referenced research from Merritt Hawkins and the Commonwealth Fund. "But what if you're an asthmatic whose breathing is deteriorating, or a diabetic whose medicines need adjustment…? In much of the country, you can wait a week or weeks for such office appointments--or longer if you need to find a doctor who accepts your insurance plan or Medicare."
And some experts expect the problem to worsen under the Affordable Care Act. "I fully expect wait times to be going up this year for Medicaid and Medicare and private insurance because we are expanding access to care, but we're not really expanding the system of providers," Steven D. Pizer, Ph.D., a healthcare economist at Northeastern University in Boston, told the newspaper.
However, recent public scrutiny over Veterans Affairs (VA) hospital wait times sheds light on the fact that most of our nation's health systems don't openly track or set standards for wait times as do other countries, particularly those with national health programs that incentivize timely preventive care as a means to keep hospitalizations down, the article noted.
While the U.S. movement away from fee-for-service toward value-based care is not complete, the transition is picking up speed. Even for primary care doctors who are not part of an accountable care organization or a patient-centered medical home, an average of 5.96 percent of their 2012 compensation was based on quality measures, according to a recent report from FierceHealthPayer. Moreover, research suggests doctors are ready to report quality measures to commercial payers and the federal government, the article noted.
To learn more:
- read the article