ON fee-for-service the americanprogress.org web site4 has this to say about it.

==============================================Fee-for-service payment system, which rewards quantity over quality, especially for high-cost, high-margin services. Under this system, health care insurers, including Medicare and Medicaid, pay doctors, hospitals, and other health care providers separately for different items and services furnished to a patient. As of 2008, 78 percent of employer-sponsored health insurance was fee-for-service.

Fee-for-service payments drive up health care costs and potentially lower the value of care for two main reasons. First, they encourage wasteful use, especially of high-cost items and services. Second, they do nothing to align financial incentives between different providers. As a result, patients receive care that they do not need and may not want, and health care providers may not be on the same page about what type of care the patient should receive. It is not just insurers who bear these unnecessary costs: These costs raise premiums, deductibles, and cost-sharing for all health care consumers.

Moreover, the fee-for-service system does nothing to encourage low-cost, high-value services, such as preventive care or patient education—even if they could significantly improve patients’ health and lower health care costs throughout the system. Many patients with poorly controlled diabetes or heart failure, for example, enter hospitals needing acute care when their conditions could be managed with better preventive disease management, which would eliminate the need for costly hospital stays.

But there are signs this trend is changing. The Affordable Care Act includes a variety of payment and delivery system reforms designed to control costs and improve care, especially in the Medicare program. These reforms both complement existing private-sector innovations and encourage even wider adoption of alternatives to the existing fee-for-service system. Instead of basing payment solely on the volume and price of the items and services provided to patients, these alternative methods of payment create incentives to encourage preventive care and better care coordination, especially for patients with chronic illnesses.

So I see you reprint liberal think tank articles.

Well watch this.  The vast majority of the increase in coverage came through expanded Medicaid and because of subsidies only available in the exchanges.  Given that Medicaid is a plan that states must contribute to, when state revenues fall, and Federal support for the exchanges ends, so too will much of this support.  And then enrollment will tumble.

ACA did NOT address the underlying problems with health care in the USA. I suggest that you chat honestly with a primary care physician, especially an OB/GYN on what they think of this.

No one is saying that what existed before (shut up baseman) was good, but the ACA is not addressing the biggest problem and that is the high cost of health care delivery in the USA.  If they switch from "fee for service:, then there will be rationing of healthcare. Until one has a heart attack an echocardiogram will not be approved.

No one is addressing the fact that health care costs are increasing faster than is the overall CPI.

In fact those who know fear that there will be a collapse of the exchanges as more and more insurance companies  walk away from them.  Most of those who benefit from ACA buy through the exchanges because that is the only way that subsidies and enhanced Medicaid is available.  So as the exchanges collapse so too does ACA!

Now go look for a liberal think tank to refute that. This will ironically be written by a wealthy liberal. Yes the same ones who demand 22 tests, which is why US doctors over medicate, and why costs are so high.  They don't mind as they have they don't buy from the exchanges, hypocrites that they are, "because their doctor isn't part of the network".

caribny posted:

So I see you reprint liberal think tank articles.

Yes - for the Fee-for-Service concept. You have a problem with this exposition?

Kari posted:

caribny posted:

So I see you reprint liberal think tank articles.

Yes - for the Fee-for-Service concept. You have a problem with this exposition?

 

High healthcare costs.

Fee for service means that services are performed to generate revenues to cover costs.  Maybe you don't know how much time healthcare providers spend in attempting to define how to bill for services provided so as to maximize what they get paid. 

Go to the doctor for your annual physical, which should be preventive care.  While there remind the doctor that you need a prescription refill.  Suddenly this visit isn't preventive any longer but one to care for high blood pressure. 

Did the doctor do anything to deal with HBP, other then pressing a button so the prescription is generated to the pharmacy?  NO. But they bill as if they did because they get paid more. Are they greedy? No because they must offset the high cost of providing care.

Cost containment means that services are curtailed to reduce costs to not exceed the fees that the healthcare provider will be paid.  Patients will not see a doctor unless they are chronically ill, as the nurse is cheaper than the doctor.

ACA does NOT deal with delivering health care efficiently.  This because politicians and lawyers and not healthcare providers are involved in this.