Payment Reform: Quality Care Pricing

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One Paragraph Description

How the public described payment reform) will improve patient care and bring down patient costs. This approach to pricing helps doctors spend more time with their patients, rather than rushing from appointment to appointment, so that we receive more personal and attentive care. It also encourages efficiency by expanding the use of electronic record keeping, cutting down on duplication of tests and medical errors. And quality care pricing will lower patient costs by requiring insurance companies to cover prevention services like mammograms and colonoscopies that keep people healthier and detect problems before they come difficult and expensive to treat.

Big Picture: A CONVERSATION ON QUALITY CARE PRICING IS TRICKY BUT WORTH THE EFFORT

  • While the public is frustrated with the quantity approach to payment, they are skeptical about a shift to a quality-based system. They ask ‘how quality can be measured?’ and ‘who would be in charge of determining quality?’ and ‘will the shift jeopardize my current care?’
  • On the one hand, they recognize that their doctors are already overworked and say, “Can we realistically expect to receive more face time with our doctors” (an important component to quality care)? On the other hand, they are opposed to the incentive approach and say, “Doctor’s shouldn’t get paid more for doing the job they are supposed to be doing.”
  • Therefore, touting that the new law will ‘reward quality care rather than quantity’ runs the risk of sounding like empty rhetoric.
  • However, discussing that the law shifts to support of quality care by focusing on encouraging doctors to spend more face time with their patients, covering prevention, expanding use of electronic medical records, encouraging coordinated patient care, grounds it for the public.

Talking Points

  • Encourages doctors to spend more time with their patients.
  • Expands the use of electronic medical records so we cut down on duplication of tests and reduce medical errors.
  • Emphasizes being and staying well by requiring insurance companies to cover prevention services like mammograms and colonoscopies. (NOTE: prevention saves ‘system’ dollars as well as ‘patient’ dollars – when talking with the public reference the savings to them. Example: You will no longer be responsible for a co-pay when it comes to prevention care).
  • *Quality care pricing – is descriptive language the public understands (NOTE: don’t use payment reform as the word ‘reform’ in healthcare has been polluted)

Don’ts

  • Connect pricing with rewards or incentives for doctors
  • Connect pricing with lump-sum payments for medical services
  • Talk about paying doctors based on positive patient outcomes