Tags: Health Topics | Healthcare Reform | Medicare | payments | flawed | VBP | lower costs

Mount Sinai Hospital Doctor: Medicare Payment Programs 'Flawed'

By    |   Thursday, 12 Feb 2015 07:39 PM

The Department of Health and Human Services is expanding Value Based Payment (VBP) programs for Medicare, but one expert thinks the agency is simply maintaining "a failed program."

Joel Zinberg, a practicing surgeon at Mount Sinai Hospital in New York City, writes in an opinion piece for The Hill that VBP programs are not working.

"While VBP is supposed to improve quality and lower costs by paying for the value and/or quality of services, rather than the volume of services, multiple studies, including some by HHS, show that VBP programs have not worked," Zinberg writes. "In practice they place tremendous burdens on physicians and distort the physician-patient relationship. This flawed experiment will impact all Americans since Medicare is a benchmark for all U.S. health insurance."

There are several types of VBP programs, and they all require healthcare providers "to report a laundry list of metrics that bear little or no relationship to improved health outcomes," Zinberg writes.

The programs, according to the doctor, are blocking independent physicians and small physician groups out of the market because of high costs. The model is instead encouraging physicians to join larger networks led by hospitals.

This, in turn, will drive up prices at the patient level.

"Research shows that healthcare consolidation and market concentration lead to increased prices — as economic theory would predict — with little or no offsetting benefits," Zinberg writes. "Price increases, not overutilization of resources, account for most of the growth in healthcare spending."

Cost control is best done through competition, which the VBP programs do not lead to, according to Zinberg.

Meanwhile, as the deadline to sign up for 2015 healthcare plans is just a few days away, HHS said earlier this week that 6.5 million Obamacare customers are saving an average of $268 per month on plans.

Still, critics of the Affordable Care Act claim it is doing more harm than good.

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The Department of Health and Human Services is expanding Value Based Payment (VBP) programs for Medicare, but one expert thinks the agency is simply maintaining "a failed program."
Medicare, payments, flawed, VBP, lower costs, studies, show, havent worked
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2015-39-12
Thursday, 12 Feb 2015 07:39 PM
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