From volume to value: Better ways to pay for health care

Health Affairs

Volumn 28, Issue 5, 2009, Pages 1418-1428

  Miller, Harold D ^a,b  

^a Network for Regional Healthcare Improvement   (United States)

^b Center for Healthcare Quality and Payment Reform   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST CONTROL; ECONOMIC ASPECT; HEALTH CARE COST; HEALTH CARE QUALITY; HEALTH CARE SYSTEM; MEDICAL FEE;

COST CONTROL; EPISODE OF CARE; FEE-FOR-SERVICE PLANS; HEALTH CARE COSTS; ORGANIZATIONAL INNOVATION; PROSPECTIVE PAYMENT SYSTEM; REIMBURSEMENT MECHANISMS;

EID: 70349211947     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.28.5.1418     Document Type: Article

References (29)

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6. There is no standard terminology for this payment approach. The term "global" is also used to mean some form of comprehensive payment. "Condition-adjusted" seems more appropriate than the more common term"risk-adjusted," since the services a patient needs from a provider depend onwhat conditions the patient has today, not just the patient's risk of mortality or morbidity in the future.
7. There would also need to be some method of making "outlier payments" or providing stop-loss protection for providers whose patients need unusually high levels of care.
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