Transition from Fee For Service?

Reed Abelson reports in Saturday’s New York Times  that hospitals which develop programs to decrease hospital readmissions financially penalized by Medicare (and most other payers).   This is not “new” news – and there has been substantial reporting on this for some time, including previous writing in the Times .  See my post from March referencing a number of other examples.  This is a story worth continuing to cover – and one of the reasons why it is challenging to lower the cost of health care with a predominately fee for service system. 

Interestingly, the commission on payment reform in Massachusetts is working toward a transition to more bundled (or even capitated) payments.   Massachusetts state officials feel that a Medicare waiver (to allow bundled Medicare payment to MA providers) is an important component of the transition  - but there are high hurdles to obtaining this waiver.  Here is a link to the most recent presentation from this commission’s public hearings.