Getting The Price Right: How Some Countries Control Spending In A Fee-For-Service System

被引:14
作者
Gusmano, Michael K. [1 ,2 ]
Laugesen, Miriam [3 ]
Rodwin, Victor G. [4 ]
Brown, Lawrence D. [3 ]
机构
[1] Rutgers State Univ, Hlth Policy, Piscataway Township, NJ 08854 USA
[2] Hastings Ctr, Garrison, NY 10524 USA
[3] Columbia Univ, Mailman Sch Publ Hlth, Dept Hlth Policy & Management, New York, NY USA
[4] NYU, Robert F Wagner Grad Sch Publ Serv, Hlth Policy & Management, New York, NY 10003 USA
关键词
HEALTH-CARE; UNITED-STATES; COMPETITION; REFORMS; PLAN;
D O I
10.1377/hlthaff.2019.01804
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Although the US has the highest health care prices in the world, the specific mechanisms commonly used by other countries to set and update prices are often overlooked, with a tendency to favor strategies such as reducing the use of fee-for-service reimbursement. Comparing policies in three high-income countries (France, Germany, and Japan), we describe how payers and physicians engage in structured fee negotiations and standardize prices in systems where fee-for-service is the main model of outpatient physician reimbursement. The parties involved, the frequency of fee schedule updates, and the scope of the negotiations vary, but all three countries attempt to balance the interests of payers with those of physician associations. Instead of looking for policy importation, this analysis demonstrates the benefits of structuring negotiations and standardizing fee-for-service payments independent of any specific reform proposal, such as single-payer reform and public insurance buy-ins.
引用
收藏
页码:1867 / 1874
页数:8
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