Role of regulation in value-based health care
Last edited Wed Oct 10, 2018, 04:00 PM - Edit history (1)
Role of regulation in value-based health care
Patient-Centered, Value-Based Health Care Is Incompatible With The Current Climate Of Excessive Regulation
By John O'Shea
Health Affairs Blog, October 3, 2018
Although still a subject of debate, the fee-for-service health care payment system that reimburses providers for individual services is widely indicted for promoting care that is inefficient, uncoordinated, and too often fails to meet the needs of patients. Whether or not fee-for-service is the main culprit, the escalating cost and inconsistent quality of US health care highlights the need for a better system. In discussions about what that system should look like, the terms “patient-centered” and “value-based” have become buzz words for payment and delivery reform in health care.
Unfortunately, many well-intentioned efforts to move to a more effective system are adding to the already substantial administrative and regulatory burden on physicians, hospitals, and other providers. In turn, these cumbersome new initiatives stifle innovation and obstruct meaningful payment and delivery reform. The current administration has appropriately recognized that this over-regulation is impeding the transition to a truly patient-centered and value-based health care system. Recently announced initiatives such as “Meaningful Measures” and “Patients over Paperwork” are promising because they aim to reduce the amount of time physicians spend on record-keeping and administrative tasks, allowing them to re-focus on patient care. However, the administration’s recent refusal to consider new payment and delivery models recommended by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) throws into question whether the Department of Health and Human Services (HHS) is serious about removing barriers to innovation.
The Impact Of MACRA
http://www.pnhp.org/news/2018/october/role-of-regulation-in-value-based-health-care
= new reply since forum marked as read
The PNHP left out the links included in the text of the original blog post for citations. That's a red flag that it's something that doesn't support the conclusion that PNHP wants.
Here a link to the full blog post, with all citations;
https://www.healthaffairs.org/do/10.1377/hblog20180927.405697/full/
Can you tell me what conclusions you reached from this? Not clear from your post, which mashes up excerpts from the already edited PNHP report with comments on the PHNP article.
Also - the snippet of an Obama quote in the rotating banner at the top of the PNHP page dated July 22, 2009:
leaves out the full context what he also said in that same July 22, 2009 press conference, cutting it off mid-sentence, which doesn't lend PNHP much credibility on that- he was answering a reporter's question about if his plan would cover every single person or fewer than that. Here's their snippet in context:
THE PRESIDENT: I want to cover everybody. Now, the truth is that unless you have a what's called a single-payer system in which everybody is automatically covered, then you're probably not going to reach every single individual, because there's always going to be somebody out there who thinks they're indestructible and doesn't want to get health care, doesn't bother getting health care, and then unfortunately when they get hit by a bus end up in the emergency room and the rest of us have to pay for it.
But that's not the overwhelming majority of Americans. The overwhelming majority of Americans want health care, but millions of them can't afford it. So the plan that has been -- that I've put forward and that what we're seeing in Congress would cover -- the estimates are at least 97 to 98 percent of Americans.
There might still be people left out there who, even though there's an individual mandate, even though they are required to purchase health insurance, might still not get it, or despite a lot of subsidies are still in such dire straits that it's still hard for them to afford it, and we may end up giving them some sort of hardship exemption.
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So tonight I want to answer those questions. Because even though Congress is still working through a few key issues, we already have rough agreement on the following areas:
If you have health insurance, the reform we're proposing will provide you with more security and more stability. It will keep government out of health care decisions, giving you the option to keep your insurance if you're happy with it. It will prevent insurance companies from dropping your coverage if you get too sick. It will give you the security of knowing that if you lose your job, if you move, or if you change your job, you'll still be able to have coverage. It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. And it will cover preventive care like check-ups and mammograms that save lives and money.
And it certainly doesn't include this quote from a few months earlier- which explains WHY he didn't support Single Payer as a solution to the US problem:
“We don’t want a huge disruption as we go into healthcare reform where suddenly we’re trying to completely re-invent one-sixth of the economy. So what I’ve said is, let’s set up a system where, uh, if you already have healthcare through your employer and you’re happy with it, you don’t have to change doctors. You don’t have to change plans. Nothing changes. If you don’t have healthcare, or you’re highly unsatisfied with your healthcare, then let’s give you choices. Let’s give you options, including a public plan that you can enroll in and sign up for. That’s been my proposal.
http://www.healthfreedoms.org/obama-single-payer-if-we-were-starting-from-scratch/
or what the rules are.
I'm talking about your own reasons for posting something that was so heavily edited.
My familiarity with O'Shea and Health Affairs is greater than you would imagine, so that observation is flawed.
I have no knowledge of O'Shea's opinon or lack of one on this post at PNHP, and don't expect him to publish one - as such I never stated that there was animosity on the part of O'Shea - strawman. I pointed out that they reprinted the blog post without the citations that the author (O'Shea) felt were important enough to link to in the text, and that in and of itself is a red flag for accuracy in research citations. Is that clearer?
"His opinion is countered by the physicians response," - OK, you finally got what I was saying... and it seems that you think that a retired physician who is lobbying for Single Payer's response to the blog "counters" that of the physican and reputable expert in health policy who authored the blog, because you support single payer, and will give more weight to any response that supports it.
I also pointed out other instance of PNHP editing an Obama quote to the point of eliminating the context that shows that Obama followed up with a statement about why Single Payer wasn't practical. You certainly don't want to discuss that, and I can see why.
"Enjoy the remainder of your day" as well.
