NJ upends how doctors get paid, so why do vaccination, C-section rates lag?
Despite incentives to promote good health, the report by Catalyst for Payment Reform found
"I'm embarrassed about all these results," said Dr.
Reedy was among the panelists at the
The scorecard assessed
Catalyst represents employers seeking to lower their health care costs. It has advocated a shift from the traditional "fee-for-service" model in which providers are paid for each service they provide to "value-based" in which providers are rewarded for their patients' outcome.
It found 52 percent of payments in 2016 from three major commercial insurers in
In short, doctors and hospitals get extra money for ensuring their patients meet certain targets like controlling high blood pressure and diabetes. They aren't penalized if they don't meet them.
It said it has seen dramatically better results with patients who receive care from those physicians. Their inpatient admissions were 4 percent lower, their colorectal cancer screenings were 6 percent higher, and their breast cancer screenings were 7 percent higher.
"We owe it to our members to continue driving changes and expanding the value-based partnerships that are making it easier for our members to get the right care, in the right setting at the right time,"
Catalyst's scorecard showed there is lots of room for improvement. In some cases,
See one unique idea to improve patient health in the video above: Bees.
But in other key indicators,
* About 60 percent of children ages 1 1/2 to 3 received all recommended doses of seven key vaccines, compared with 71 percent nationwide.
* Nearly 30 percent of women with low-risk pregnancies get C-sections anyway, compared with a target rate of 23 percent.
* Some 52 percent of people with hypertension had adequately controlled blood pressure, compared with 54 percent nationwide.
* And 84 percent of adults said they received information about how to recover at home, compared with more than 87 percent nationwide.
Tying at least some of the payment model to value is a good start, but "we need to go faster,"
MORE: NJ will issue report card to reduce C-section rate
Flipping around the payment system alone might not be enough to improve the state's collective health.
Health systems still need to invest in technology to help them coordinate care among their doctors. They need to hire social workers and case managers to stay connected with patients.
And primary care doctors still receive just 20 percent of reimbursements even though they are on the front line of the new health care model. Specialists receive 80 percent, Caballero said.
"I do think payment reform can impact these results, but it has to be adequate payment to support the work," said Reedy, from
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