Virtual partnerships: aligning hospital and surgeon incentives

Abstract 

Background

Payment schemes exist for health care in the United States that are perverse and, in many cases, antithetical to the goals of all concerned. A fundamental reorganization will be required if care is to be broadened and sensible economies achieved.

Methods

For some time, we have experimented intellectually with reorganization of the specialist/hospital axis in contemporary medical care, seeking a more functional relationship among the parties (ie, doctors, nurses, hospitals, and their patients).

Results

A virtual partnership between surgical specialists and the hospital provides many of the favored factors for productive and mutually respected care for patients with a feasible method for limiting costs.

Conclusions

A virtual partnership, as exemplified for 3 major surgeries, could create a relationship that benefits the patient, the surgical specialist, the hospital, and the ethical payer.

Keywords: Risk adjustment, Adverse outcomes, Bundled payments, Physician-hospital relationships, Pay-for-performance, Healthcare payment incentives