Under the Knife: Public, Private Insurers Cut Into Fee-For-Service Health Plan

by Mark Friedman  on Monday, Apr. 9, 2012 12:00 am  

Public and private insurers are cutting into fee-for-service business plans.

“Physicians are taking a wait-and-see attitude,” said David Wroten, executive vice president of the Arkansas Medical Society. “They’re not sure how it’s going to affect them.

“There’s a lot of anxiety and a lot of concern out there about how is this going to affect physicians and their patients.”

Wroten also said that he didn’t think the new pay model was a panacea, because he doesn’t know its outcome.

“Does it seem like an appropriate thing to try? Yes,” he said. And he added that the physicians have been helping DHS officials craft the new payment model.

Paul Cunningham, senior vice president of the Arkansas Hospital Association, also said he didn’t know what the new payment system will mean for hospitals.

“Certainly initially we don’t think it’s going to save a lot of money,” Cunningham said. But he said hospital officials are working with DHS to provide input.

Allison, the director of Medicaid, said he didn’t have a projection on what the savings will be. “We’re optimistic that it will reduce costs and change the trajectory of growth,” he said.


Allison said the goal of the reform is to pay for quality and efficiency in health care.

“We just have to get away from paying for volume,” he said.

Arkansas Surgeon General Joe Thompson, who is working with Medicaid to reform the system, said that under the fee-for-service mo-del, no one manages the entire experience of the patient.

As a result, when someone enters the hospital for, say, congestive heart failure and is treated and discharged, no one is assigned to make sure the patient is getting the medication he needs when he gets home, he said.



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