Jaan Sidorov of the Disease Management Care Blog did an excellent job with the latest edition of the Cavalcade of Risk. There’s plenty of good reading there, so don’t miss it. I thought one of the most interesting posts was from Dr. Sidorov himself, writing about bundled payments. He makes some really going points, explaining how bundled payments aren’t as simple as they might sound on an administrative level, and might not be as effective as proponents claim. There certainly appear to be some conflicts of interests when you look at what insurers, doctors, hospitals, and patients want. It’s possible that bundled payments could work for some of the simplest health care scenarios (for example, basic maternity and delivery care with no complications), but if complications or other health conditions are thrown into the mix, the billing and payment could get messy pretty fast.
There’s a lot of talk lately about another compensation system that pays doctors based on how healthy their patients stay, but there are plenty of factors there that might be outside of the doctor’s control. There certainly are no easy answers, and Jaan’s article is a good reminder that there is still much work to be done in figuring out how we lower health care costs, optimize utilization, and fairly compensate providers, all at the same time.