title: Paying fairly for good outcomes: which formula works?
abstract: I see the single-based payment systems moving more toward the middle, toward an American-style system using competitive bidding with outcomes-based focus. The American system is moving in the opposite direction despite knowledge of the flaws of a single-payment system. Modernizing our payment system by desegregating Medicare Part A and Part B, applying information technology, and value-based reimbursement along with a bold move toward an HSA methodology could empower patients and physicians, reinvigorate our system with cost savings, and move us in the direction that all industries in a free market system should have the freedom to move.
authors.affiliation: Department of Nephrology and Hypertension at St. John Hospital and Medical Center, Detroit, Mich, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Provenzano
mesh_terms: D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics*; D012051:Reimbursement Mechanisms / Q000191:economics* / Q000458:organization & administration*; D006435:Renal Dialysis / Q000191:economics*