Herewith a very useful discussion in MedPage Today by health-policy experts  and providers on the Department of Health and Human Services’ plan to  phase out Medicare traditional fee for service based on volume and instead pay providers according to quality and value of care.

The questions discussed:

“What are the most appropriate alternative payment models?”

“How much impact on quality and cost of care do you expect to see?”

“What unintended consequences do you worry about?”

Among the more interesting remarks were those of Richard Kravitz, M.D., who said:

”{R}egardless of the accounting scheme, value-based payment requires systems for measuring both medical risk and quality reproducibly and accurately. Our ability to measure quality at the aggregate level is excellent, but quality assessment at the individual level lags far behind.”