A collaboration of UC Berkeley health policy experts, government health regulators and leaders of California’s largest health insurance and health provider plans says it has devised a road map that would provide more cost-efficient and better health care to more Californians.
The report from the Berkeley Forum for Improving California's Healthcare Delivery System proposes a system of coordinated care and a way of paying health providers that would save California $110 billion during the next decade.
Key among the plan's seven initiatives is a call to ditch today’s fee-for-service payment model – which pays health care providers for each test or treatment that's ordered.
"Right now about 79 percent of the (health care) expenditures in California are still fee-for-service," says Stephen M Shortell, dean of the UC Berkeley School of Public Health and chairman of the Berkeley Forum. "The more that's done to us the more people get paid. This is not a good way to deliver health care in the 21st century. It results in a lot of re-testing... duplicate care and inefficiencies."
Shortell says the group's report calls instead for a risk-adjusted "global budget" that factors in patient satisfaction, innovation and risks associated with various patient populations.
"That's what's beginning to start in California and what this group is calling for in a rather radical way to speed it up," Shortell says.
The plan calls for more coordinated care health plans and better access to primary care. It says that can be achieved by changes in state law that would allow nurse practitioners, pharmacists and other health care workers to provide more patient care.