The video entitled “Health Quality Summit: Promoting Quality through Payment Redesign,” which was filmed from the US Department of Health and Human Services National Summit on Health Care Quality and Value on October 4, 2010, is a nearly hour-long panel discussion that encompasses the types of payment methods currently in place in United States heath care as well as which of those payment types works best and which don’t work very well. The video begins with an emphasis on a capitated method of payment from the government to physicians that the panel feels is very cost efficient and contains the best outcomes for both patients and physicians. The panel also discusses outcomes of other types of physician reimbursement programs and throws out a lot of statistics and canned language regarding physician reimbursement. Also discussed are the electronic medical record, shared savings plans, new models of medical plans, and future payment systems.
One of the most interesting aspects of this video is at about the 18-minute mark when one of the panelists discusses the “visibility” and “invisibility” of payment plans and payment reform at the patient level. This panelist also talked about “high-value” providers. His discussion of health care payment reform was shocking. First, he discussed how not being transparent (in a doctor patient relationship) can actually be beneficial in the sense that if a patient knows there are alternatives for care available and is not offered those alternatives due to the fact that they are not covered by his insurance, the patient will become upset. This panelist was promoting “invisibility” as a way to keep peace in the system. This is an abhorrent sentiment. Also, this panelist discussed “high-value” providers, meaning the ones who generated the most savings for CMS. I would hope that a high-value provider would be defined as one who gives good care to his or her patients rather than as how he or she saves an insurance provider money, governmental or not.