Health Affairs, 28, no. 5 (2009): 1372 doi: 10.1377/hlthaff.28.5.1372 © 2009 by Project HOPE	New Online   Senate Health Reform Bill   Rewarding Providers   Public Option Policy Brief   Health Reform & Abortion   Delivery System Reform

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Changing Incentives

PROLOGUE

Changing The Incentives Through Payment Reform

There’s broad agreement that the fee-for-service payment system that dominates U.S. health care should be altered—to provide fewer incentives for volume and better incentives for cost-effective care. Yet there’s little consensus on proposed changes. The following papers examine some alternatives: a few that are already being tried, such as pay-for-performance (P4P) schemes, and others that may be incorporated into state or national health reforms. Clearly, politically and technically, it will be difficult to craft a "Goldilocks" compromise—not too strict, not too loose, but somehow just right.

At one extreme are proposals to shift from fee-for-service in the direction of capitation—fixed . . . [Full Text of this Article]

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