Maryland's approach in enhancing effectiveness and efficiency in healthcare delivery: comment on 'Achieving cost control, care coordination, and quality improvement through incremental payment system reform'.

摘要

IN the article "Achieving cost control, care coordination, and quality improvement through incremental payment system reform, " the authors provide a valuable and often overlooked context (the design principles of Medicare's inpatient prospective payment system or IPPS) for their very broad but practical set of recommendations on the development of incentive structures to control costs and improve quality of care simultaneously. The methods they otitline are directed explicitly at reforming the Medicare program but most of the authors' recommendations are, of course, applicable to both public and private payment models alike. As in the past, government can play the role of innovator in the development of enhanced payment mechanisms and in linking payment to improved quality of care. Systems that prove effective can then be readily adopted by major private payers.