HealthcareTrends in regulation of Healthcare reform with the potential for the most positive effect on care quality, sustainability of organizations and why they are so important
Reforms in payments, anchored on recent patterns in the private and public sectors are needed to support high quality interventions that matter to patients. Medicare has moved towards payments that are aimed at person-level healthcare. Such measures include DRG payments and penalties that have been recently applied for readmissions, person-level payment remissions in the Accountable Care Organization, Person level payment remissions in the Medicare Advantage program, reforms such as the Medicare Shared Savings Program, present and past pilot episode payments and the Pioneer pilot plan. However, Medicare payments are largely based on fees for service. Although the quality interventions at person level sought currently are not ideal, patients and providers can still gain from the change of their payments drawn from fee-for service. It allows providers to give individual-focused service as opposed to what is covered under fee-for-service. Many physician specialists across the board have pointed out ways in which some amount of their fee-for service can be directed to person-level or episode payments in the short-term to obtain...
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