Archive for category Risk Adjustment

Time for Insurers to Put Their Money Where Their Mouth Is

With large scale health insurance reform looking doomed with Nancy Pelosi’s claim on Friday that she doesn’t have the votes to pass the Senate health care reform bill, it is time to return to the black board for incremental reforms.  One of the most promising areas could be payment reform, particularly Medicare payment reform.

Payment reform was the unspecified part of the bill that was supposed to provide long term cost control.  Unlike some backroom deal for the Nebraska Medicaid population, there was a valid reason for payment reform to be unspecified:  nobody has a clear idea about what will work.  The key problem is how do you measure non-events?  How do you reward care providers for not having to perform services in the first place? Read the rest of this entry »

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