4.4: Organization & Payment

Adopt better ways to organize and pay for health care.

Other Information:

The delivery of health care in the U.S. largely takes place through small, independent physician-led practices. Doctors' pay largely reflects the number of medical services they provide to patients, not the number of people whose health they improve. This "fee-for-service" system rewards doctors and other providers when they perform medical services for their patients, regardless of the impact on patient health. Within this system, there is little coordination of care as each health care professional treats a specific condition or illness. Options to reform the way medical care is organized and paid for could improve focus on the "whole patient" through better coordination and integration of patient care. Such delivery system reforms could improve overall health while reducing duplicative, unnecessary, and potentially harmful services. Some alternatives to fee-for-service health care include: accountable care organizations (ACOs), integrated clinics, and bundled payment systems. Many of these systems have demonstrated that they can achieve greater value in health care. They give health professionals greater incentives to perform those medical services that are the most effective and necessary to improve overall patient health. By identifying the barriers to the creation of these types of care systems and encouraging the development of more of them, we could improve the value we get from health care.

Stakeholder(s):

• Doctors


• Health Professionals

Indicator(s):

Indicator:1

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