22 Oct Shared Savings May Promote Lower Costs With Equally Effective Health Care
MedicalResearch.com Interview with
Dr. Harald Schmidt, MA, PhD
Assistant Professor, Department of Medical Ethics and Health Policy , Research Associate, Center for Health Incentives and Behavioral Economics, Perelman School of Medicine
University of Pennsylvania Philadelphia, PA 19104-3308
Medical Research: What are the main findings of the study?
Dr. Schmidt: We reviewed currently available policies for aligning cost and quality of care. We focused on interventions are similar in their clinical effectiveness, have modest differences in convenience, but pose substantial cost differences to the healthcare system and patients. To control health care costs while ensuring patient convenience and physician burden, reference pricing would be the most desirable policy. But it is currently politically unfeasible. Alternatives therefore need to be explored. We propose the novel concept of Inclusive Shared Savings, in which physicians, the healthcare system, and, crucially, patients, benefit financially in moving more patients to lower cost but guideline concordant and therapeutically equivalent interventions.
Medical Research: What should clinicians and patients take away from your report?
Dr. Schmidt: Inclusive Shared Savings offers financial incentives to physicians and patients to promote the use of lower-cost, but equally effective interventions. The approach has promising potential to undercut the significant budgetary impact of supply-induced demand resulting from the prescribing of no- or low-value interventions. Moreover, it can shield patients financially by eliminating or reducing their copayments and providing a positive financial incentive to opt for lower cost tests and treatments. Inclusive Shared Savings also encourages patient reflection on value for money and promotes culture change. Emotionally, Inclusive Shared Savings helps patients to appreciate that they receive adequate care, offering reassurance in a situation where many feel vulnerable in their exposure to a bewildering array of interventions that—knowingly or unknowingly—exploit the politics of hope.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Schmidt: Strategies for gaining broader acceptability of reference pricing need to be identified. In the meantime, Inclusive Shared Savings should be evaluated in a rigorous trial or demonstration project as the current policy options are unsatisfactory.
Citation:
Last Updated on October 22, 2014 by Marie Benz MD FAAD