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Mayo Clinic: Use 'value scores' to keep health care costs down

Posted On Thu, September 24, 2009

As the debate as to how health insurance can be provided universally while keeping health care costs efficient, Mayo Clinic president Dr. Denis Cortese and board of trustees member Dr. Jeffrey Korsmo think the current health care system has become a victim of overspending and would benefit from an incentive-based pay plan to drive prices down while maintaining quality care.

In an article published in the current New England Journal of Medicine, Cortese and Korsmo state that reforms should make Medicare payments to doctors based partly on "value scores" that would reward those who provide cheap and adequate care. This, they argue, would encourage others to do the same to improve their scores, and therefore provide more universally affordable health care that does not lack in quality or drive up health insurance rates.

They add that the value scores would be used as a basis to pay doctors on scale depending on how cost-efficient and quality-oriented they were in a number of their payment plans, while taking into account clinical outcomes, safety, and patient-reported satisfaction. That way, doctors who find a way to properly diagnose conditions more efficiently would create a "value gap" in the market that other doctors could only close by becoming more efficient.

"Health care professionals would then begin to compete on the elements that matter most - outcomes, safety, service, and cost. Providers with worse outcomes, less-satisfied patients, and higher costs would lose patients, which would spur them to improve value," the report reads.

The pair concludes by suggesting that Congress could be an initiator of such reform by implementing a three-year deadline for creating and implementing new payment methods for Medicare.
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