Suppose a boss in a widget-manufacturing firm told the company’s work force that from now on, employees would have their pay based on punching in and out on time and producing a certain number of widgets during a shift.

The quality of the widgets, however, would be entirely irrelevant to a worker’s salary. No one would be surprised if that meant widgets weren’t put together very well.

Yet, that is how much of our health care reimbursement system is financed: Providers see a certain number of patients in a set time frame, and are paid on either a per-patient or per-procedure schedule.

How many patients got better is unimportant. Indeed, the more times sick patients were seen, the more a provider’s income would rise.

But Maine physicians are being offered an opportunity to break out of that mold. Under the auspices of Medicare, the federal Office of Health Care Innovation is putting up $26 million over the next three years to conduct an experiment in Maine aimed at primary care physicians.

The goal is to reward doctors for preventing disease as much as treating it, lowering the numbers of hospitalizations and complications, in the hopes of bringing overall expenses down while creating a healthier population.

The money will go to expand a pilot program already in place in 26 medical practices around the state called the “patient-centered medical home.” Other practices are already experimenting with the model even without additional funding, and seven other states are also involved in the Medicare program.

Hopes are high that rewarding those who keep patients healthy is the path not only to savings, but to healthier citizens nationwide.

 


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