Third Party Insurance Case Study
Payment policies must change to motivate providers to deliver value (broadly defined as health benefits per dollar spent) rather than volume (the number of exams, tests, procedure, and treatments).
Apply the best available evidence to eliminate wasteful and inappropriate care. The best prospects for success are likely to come through the leadership of medical specialty societies, which can identify ways to reduce waste without compromising care. These groups could draw from emerging comparative effectiveness reviews and provide guidance that physicians can use to determine which procedures are necessary, appropriate, equivocal, or inappropriate in various situations.
Enhance patient safety. Medical errors cause needless complications, injuries, readmissions, and deaths. They also increase providers' liability. Measures to enhance patient safety and improve quality must be tailored to specific patients and settings.
Strengthen primary care. Strengthening primary care could help reorient our health care system from episodic treatment to keeping patients out of the hospital, thereby lowering costs and improving care.
2. Engaging and Empowering