Minnesota Physician October 2011

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Volume XXV, No. 7

October 2011

The Independent Medical Business Newspaper

Payment incentives Next-generation models will emphasize total cost of care By Ann Robinow

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Terms of engagement evolving focus on the need for he world used to be Co-creating longitudinal support of health much simpler, or at issues, requiring increased our future least it seems that way involvement of our patients. to many of us who practiced with patients While we may use different health care in the ‘70s and terms—engagement, involveBy Gary ‘80s. The prevailing paternalisment, empowerment, activaOftedahl, MD tic attitude that permeated the tion—in our discussions, all of health care system at that them speak to time meant that patients the need to have active particiwould enter our facilities seeking an expert pation from patients and, in opinion, be given a definitive diagnosis, and many cases, their family and sent on their way. The assumption on both other caregivers. But while we sides was that the wisdom and expertise often have a clear understandimparted at the clinic or hospital visit ing as citizens of our role as would be passively transferred, pending the we interact with mechanics, next acute intervention of our patient with lawyers, or financial advisers, the health care system. the roles and responsibilities Today, we physicians are confronted of physicians and patients with an explosion of new technology, increasingly complex interventions, and an ENGAGEMENT to page 10

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hanges in health care payment incentives are slowly creeping into physician consciousness, though many physicians are still oblivious, in denial, or believe we’ve been here before and this, too, shall pass. Is a change in payment incentives for real this time? Right now and for the foreseeable future, this market is in transition, creating contradictory messages to the health care delivery system. For physicians trying to navigate between the old world (fee-for-service) and new world (total cost of care) of payments, it’s a challenging time. Why should physicians care about preparing for changes in incentives? Two reasons: First, it matters to your patients. Second, it IN THIS ISSUE: matters to you. Health care Premium and costreform sharing affordability is a Page 20 growing problem for patients. Physicians are PAYMENT to page 12

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