THE ONLY INCENTIVE FOR PROVIDERS TO CONTROL PRICES...:

Death panel? No -- A promising way to control health costs (Joshua Gordon, 6/13/11, CNNMoney)

[I]n either vision, the cost of care will be driven by what doctors say to their patients during office visits or in hospital rooms.

This is why the board, known as IPAB, is so important in the effort to control costs.
How the IPAB will work

It will be made up of 15 experts, some suggested by congressional leaders and all confirmed by the Senate, appointed by the president to represent the major participants in the health care system, including patients.

These board members will not force doctors to hold back necessary, but expensive treatment, as some critics have charged. They also will not "ration" and choose who deserves to be treated. In fact, IPAB is specifically prohibited from rationing and limiting Medicare benefits, increasing costs for beneficiaries, and raising taxes.

Instead, while Congress retains the ultimate power over Medicare, IPAB will help ensure that innovations in cost control will get a fair trial based on medical expertise rather than political pressure. [...]

[W]e need to focus on giving incentives to providers to reduce costs.

Instead of paying doctors more for volume, we could pay for quality.

Instead of having primary care doctors and specialists work separately, doctors could receive bonuses if integrated care saves costs.

Instead of having clinical practices differ based on where a doctor went to medical school, we could create well-designed studies to determine best practices. And instead of patients lacking a meaningful way to compare providers, we could offer incentives for providers that participate in public databases.

The 2010 health care law sets up experiments and pilot projects to see what works. Medicare has had previous pilot projects succeed at controlling costs, only to see more widespread adoption unfortunately blocked by a determined few in Congress.

But that's where IPAB comes in. The health care law delegates some of Congress's management to a panel of experts -- IPAB.

As established, IPAB will review such experiments and recommend which deserve widespread adoption. These will then be automatically implemented unless Congress and the president enact laws vetoing IPAB's recommendations. Furthermore, the recommendations will come annually, beginning in 2013, if the health law's savings targets aren't met, making them difficult to continually thwart.

Ultimately, IPAB will attempt to keep health care costs growing at the rate of economic growth plus one percent -- well below historic rates. The additional hope is that the board's recommendations will influence payment policy among private insurers and help slow costs system-wide.

...is consumers who won't pay them. Besides, at the point where the consumer is in the hospital listening to the doctor you've already lost the cost containment battle.

Posted by oj at June 13, 2011 6:04 AM
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