Ryan Gamlin, a former healthcare-management consultant and currently a medical student at the University of Cincinnati, has written a very useful and insightful commentary in Medical Economics on why the U.S. can’t control healthcare costs and has mediocre outcomes compared to other developed democracies.
He concludes:
“New reimbursement structures, like shared savings and ACOs, will draw provider and payer incentives closer to one another – and it is within these highly aligned arrangements that the efforts of physician stewardship organizations, such as Costs of Care and Choosing Wisely, will likely be most effective.
“But with 53% of physician reimbursement {still} tied to fee-for-service, the majority of dollars saved through these efforts are still subject to recapture by insurers, administrators, or other entities, rather than making their way back to patients in the form of lower out-of-pocket costs.
“As Holman W. Jenkins {of The Wall Street Journal} pointed out in a recent, devastating satire of the Epi-Pen scandal, many of the incentives in the current healthcare system are aligned only with growing the total scale of healthcare expenditures, not shrinking them.
“Until we create a system that rewards investment in wellness and healthcare dollars not spent, there is reason to fear that the negative effects of healthcare excesses will continue to be borne by households, businesses, and governments.”
To read his whole piece, please hit this link.