Dive Brief:
- A group of doctors have written up an article for Health Affairs arguing that shifting from FFS to bundled payment could harm ED care.
- Dr. Jesse Pines of George Washington University, along with three other ED physicians, notes that testing and admissions are seen as 'safe harbors' which reduce medical liability and are well compensated; he argues that changing this reimbursement requires a carefully thought-out response.
- In addition to impacting doctors, flat fees in the ED would make it more likely safety-net hospitals would close their EDs, as they're often money-losers already, Pines suggests.
Dive Insight:
There's some situations where value-based, bundled payment seems to make sense, especially procedures like a hip replacement which have a well-defined beginning, middle and end. However, moving to capitation or bundled payment too quickly and embracing it too widely could cause huge problems, not the least of which include driving under-capitalized doctors or even hospitals out of business. (There's a number of reason capitation fell out of favor before.) Payers would be well-advised to more slowly and carefully when it comes to any changes in the structure of compensation.