Roles of Employers and Health Plans in the U.S. Health Care System

Roles of Employers and Health Plans in the U.S. Health Care System

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Week 5 Suggested Readings (September 30-October 6, 2013)
Basics of Provider Payment
Robinson, J.C. “Theory and practice in the design of physician payment incentives.” The Milbank Quarterly 2001;79(2):149-177.
Averill, R.F., Goldfield, N.I., Vertrees, J.C., McCullough, E.C., Fuller, R.L., Eisenbandler, J. “Achieving cost control, care coordination, and quality improvement through incremental payment syste
*Berenson, R.A., Rich, E.C. “US approaches to physician payment: the deconstruction of primary care.” Journal of General Internal Medicine 2010;25(6):613-618.
*Reinhardt, U.E. “The options for payment reform in U.S. health care.” New York Times online, February 17, 2012.
Use of Provider Payment to Encourage and Reward Quality Improvement
Reinhardt, U.E. “Making surgical complications pay.” Journal of the American Medicine Association 309(15):1634-1635, 2013.
Christianson, J.B., Leatherman, S., Sutherland, K. “Lessons from evaluations of purchaser pay-for-performance programs: a review of the evidence.” Medical Care Research and Review 2008;65(6 suppl)
Rosenthal, M.E., de Brantes, F.S., Sinaiko, A.D., Frankel, M., Robbins, R.D., Young, S. “Bridges to excellencerecognizing high-quality care: analysis of physician quality and resource use.” Ame
Werner, R.M., Dudley, R.A. “Making the ‘pay’ matter in pay-for-performance: implications for payment strategies.” Health Affairs 2009;28(5):1498-1508.
Werner, R.M., Kolstad, J.T., Stuart, E.A., Polsky, D. “The effect of pay-for-performance in hospitals: Lessons for quality improvement.” Health Affairs 2011;30(4):690-698.
Rau, J. “Effort to pay hospitals based on quality didn’t cut death rates, study finds.” Kaiser Health News, March 28, 2012.
Use of Provider Payment to Encourage and Reward Quality Improvement – Field of Practice
Editorial. “A view from the safety net.” Journal of the American Medical Association 309(21):2221-2222, 2013.
Mathews, A.W. “WellPoint helps cut employers’ health cost.”…

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