Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reform.
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ABSTRACT:
SUBMITTER: Einav L
PROVIDER: S-EPMC7431052 | biostudies-literature | 2020 Aug
REPOSITORIES: biostudies-literature
Publications
Randomized trial shows healthcare payment reform has equal-sized spillover effects on patients not targeted by reform.
Einav Liran L Finkelstein Amy A Ji Yunan Y Mahoney Neale N
Proceedings of the National Academy of Sciences of the United States of America 20200727 32
Changes in the way health insurers pay healthcare providers may not only directly affect the insurer's patients but may also affect patients covered by other insurers. We provide evidence of such spillovers in the context of a nationwide Medicare bundled payment reform that was implemented in some areas of the country but not in others, via random assignment. We estimate that the payment reform-which targeted traditional Medicare patients-had effects of similar magnitude on the healthcare experi ...[more]
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Project description:Racism reduces eligibility for health insurance and access to high-quality care for people of color in the United States, and current payment structures exacerbate the resultant de facto racial segregation. Payers and health plans do not adequately support and incentivize clinicians and health care delivery organizations to meet the health needs of minoritized communities. This article describes foundational work needed to create an antiracist culture of equity; the Roadmap to Advance Health Equity; and specific, actionable antiracist payment reform strategies, including increasing access to and the scope of health insurance coverage, antiracism accountability in managed-care contracts, support for the safety-net system, strengthened nonprofit hospital tax status requirements, and payment incentives to advance health equity. Antiracist payment reforms have great potential to desegregate health care systems and to ensure that everyone has a fair opportunity to receive good health services and optimize their health.
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