Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-27T21:49:17.089Z Has data issue: false hasContentIssue false
  • English
  • Français

Payment Theory and the Last Mile Problem

Published online by Cambridge University Press:  01 January 2021

John V. Jacobi
Get access Rights & Permissions [Opens in a new window]

Abstract

Health reform debate understandably focuses on large system design. We should not omit attention to the “last mile” problem of physician payment theory. Achieving fundamental goals of integrative, patient-centered primary care depends on thoughtful financial support. This commentary describes the nature and importance of innovative primary care payment programs.

Type
Symposium Articles
Information
Journal of Law, Medicine & Ethics , Volume 48 , Issue 3: A Bold Agenda for the Next Steps in Health Reform , Fall 2020 , pp. 474 - 479
Copyright
Copyright © American Society of Law, Medicine and Ethics 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

The reference to “physician” in this commentary is intended to be read broadly as including an advanced practice nurse, a physician's assistant, or other health professional providing primary care.Google Scholar
See, e.g., Johnson, M.et al., “Medicare For All: An Analysis Of Key Policy Issues,” Health Affairs 39, no.139 (2020).CrossRefGoogle ScholarPubMed
See, e.g., Wiley, L. F., “Medicaid for All? State-Level Single- Payer Health Care,” Ohio State Law Journal 79, no. 843 (2018).Google Scholar
See, e.g., Gluck, A. R. and T. Scott-Railton, “Affordable Care Act Retrenchment,” Georgetown Law Journal 108, no. 495 (2020):Google Scholar
N. Mulvaney-Day et al., “Mental Health Parity and Addiction Equity Act and the Use of Outpatient Behavioral Health Services in the United States, 2005–2016,” American Journal of Public Health S190 (2019).CrossRefGoogle Scholar
L. Adler et al., “Understanding the bipartisan Senate Finance prescription drug reform package,” Brookings Institution, October 3, 2019, available at <https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2019/10/03/understanding-the-bipartisan-senate-finance-prescriptiondrug-reform-package> (last visited July 22, 2020).+(last+visited+July+22,+2020).>Google Scholar
J. Tolbert et al., Key Facts about the Uninsured Population (KFF, December 13, 2019) available at <https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population> (last visited July 22, 2020).+(last+visited+July+22,+2020).>Google Scholar
S. Collins et al., “Health Insurance Coverage Eight Years After the ACA,” Commonwealth Fund, February 7, 2019, available at <https://www.commonwealthfund.org/publications/issuebriefs/2019/feb/health-insurance-coverage-eight-years-afteraca> (last visited July 20, 2020).+(last+visited+July+20,+2020).>Google Scholar
Sommers, B.et al., “Health Insurance Coverage and Health — What the Recent Evidence Tells Us,” New England Journal of Medicine 377, no. 586 (2017).CrossRefGoogle ScholarPubMed
See e.g., Hitchner, C. H. et al., “Integrated Delivery Systems: A Survey of Organizational Models,” Wake Forest Law Review 29, no. 273 (1994).Google Scholar
See, e.g., Greaney, T. L., “Regulators as Market-Makers: Accountable Care Organizations and Competition Policy,” Arizona State Law Journal 46, no. 1 (2014).Google Scholar
Elhauge, E., “Why We Should Care About Health Care Fragmentation and How to Fix It,” in The Fragmentation of U.S. Healthcare: Causes and Solutions, E. Elhauge ed. (2010); To Err is Human: Building a Safer Health System, L. T. Kohn et al. eds. (Washington, DC: National Academies Press, 2000).Google Scholar
See Berwick, D. M. et al., “The Triple Aim: Care, Health, and Cost,” Health Affairs 27, no. 3 (2008).CrossRefGoogle ScholarPubMed
Id.Google Scholar
Speta, J., “Handicapping the Race for the Last Mile?: A Critique of Open Access Rules for Broadband Platforms,” Yale Journal on Regulation 39, no. 1 (2000); S. Balm et al., “Developing an Evaluation Framework for Innovative Urban and Interurban Freight Transport Solutions,” The Procedia - Social and Behavioral Sciences 125 (2014): 386-397.Google Scholar
Ellner, A. L. and Phillips, R. S., “The Coming Primary Care Revolution,” The Coming Primary Care Revolution, 32, no. 4 (2017): 380–386.Google Scholar
See Wise, C.G. et al., “Journey Toward A Patient-Centered Home: Readiness for Change In Primary Care Practices,” Journey Toward A Patient-Centered Home: Readiness for Change In Primary Care Practices, 89, no. 3 (2011): 399–424; Institute of Medicine, To Err is Human: Building a Safer Health System, supra note 12.Google Scholar
See Jackson, G. L. et al., “The Patient-Centered Medical Home: A Systematic Review,” Annals of Internal Medicine 169 (2013): 169–178.Google Scholar
Id.Google Scholar
DeVoe, J.et al., “Perspectives in Primary Care: A Conceptual Framework and Path for Integrating Social Determinants of Health Into Primary Care Practice,” Annals of Family Medicine 14, no. 2 (2016):104–108.Google ScholarPubMed
See Green, K.and Zook, M., “When Talking About Social Determinants, Precision Matter,” Health Affairs Blog, October 29, 2019, available at <https://www.healthaffairs.org/do/10.1377/hblog20191025.776011/full/> (last visited July 22, 2020).+(last+visited+July+22,+2020).>Google Scholar
See Garg, A., et al., “Addressing the Social Determinants of Health Within the Patient-Centered Medical Home: Lessons From Pediatrics,” JAMA 309, no. 19 (2013): 2001–2002.CrossRefGoogle ScholarPubMed
See Devoe et al., supra note 20.Google Scholar
See Blumenthal, D.and Abrams, M. K., “Tailoring Complex Care Management for High-Need, High-Cost Patients,” JAMA 316, no. 16 (2016): 1657–1658.CrossRefGoogle ScholarPubMed
See S. Thompson et al., Economic Crisis, Health Systems and Health in Europe: Impact and Implications for Policy (European Observatory, World Health Organization, 2014), available at <http://healthrights.mk/pdf/Vesti/2014/10.2014/2/Economic-crisis.pdf> (last visited Sept. 16, 2020).+(last+visited+Sept.+16,+2020).>Google Scholar
See Health System Performance Comparison: An Agenda for Policy, Information and Research (European Observatory, World Health Organization 2013) available at <http://www.euro.who.int/__data/assets/pdf_file/0009/244836/Health-System-Performance-Comparison.pdf> (last visited July 22, 2020).+(last+visited+July+22,+2020).>Google Scholar
See Busse, R.et al., “Diagnosis Related Groups in Europe: Moving Toward Transparency, Efficiency, and Quality in Hospitals?” The British Medical Journal 346 (2013): f3197, available at <https://www.bmj.com/content/346/bmj.f3197> (last visited July 22, 2020).CrossRefGoogle Scholar
See J. C. Langenbrunner and X. Liu, How to Pay?: Understanding and Using Incentives (Health, Nutrition, and Population Discussion Paper, The World Bank), available at <http://documents.worldbank.org/curated/en/639231468762613437/pdf/316330HNP0LangenbrunnerCh5HowtoPayFinal.pdf> (last visited July 22, 2020).+(last+visited+July+22,+2020).>Google Scholar
See Tsiachristas, A.et al., “Exploring Payment Schemes used to Promote Integrated Chronic Care in Europe,” Exploring Payment Schemes used to Promote Integrated Chronic Care in Europe, 113, no. 3 (2013): 296–304.Google Scholar