Recommendations of the 2007 NRHI Payment Reform Summit

2007 PMT Reform CoverIn many cases, current healthcare payment systems don’t reward efforts by physicians, hospitals, and others to improve the quality and reduce the costs of health care. In fact, all too often, they actually financially penalize them. This has led to a variety of pay-for-performance (“P4P”) programs which add a new layer of rewards and incentives on top of the existing payment systems. While well-intended, there is a growing recognition that most current pay-for-performance initiatives won’t by themselves solve the fundamental problems and disincentives that are built into the underlying payment systems.

On March 29, 2007, the Network for Regional Healthcare Improvement convened a one-day, invitation-only national Summit on Creating Payment Systems to Accelerate Value-Driven Health Care in Pittsburgh, Pennsylvania. The Summit was designed to accelerate thinking about how healthcare payment systems can be redesigned to reward improved quality and lower costs. The Summit was not a typical “conference,” but rather a working meeting that brought together the people who must collaborate if innovative solutions will ever succeed – major healthcare payers, health plans, regional coalitions, researchers, and other thought leaders. Attendance included nearly 100 regional and national leaders from around the country who are working at the frontier of these issues.

This report describes the recommendations of the Summit participants regarding the types of payment systems that should be implemented in order to improve the quality and reduce the costs of healthcare.