International Journal for Quality in Health Care Advance Access originally published online on June 22, 2006
International Journal for Quality in Health Care 2006 18(4):261-263; doi:10.1093/intqhc/mzl010
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International Journal for Quality in Health Care vol. 18 no. 4 © The Author 2006. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Editorial |
The right incentives for high-quality, affordable care: a new form of regulated competition
| The first 150 words of the full text of this article appear below. |
In most Western health care systems, producing high-quality care efficiently is not rewarded by higher revenues. ‘Pay for performance’ schemes have emerged, rewarding improved performance of providers through financial incentives, but these schemes are simply overlaid on systems that are flawed [1,2]. In this editorial, we discuss a system with patients and providers in the leading roles, not imposing impossible burdens on patients, which induces providers to take the lead in providing high-quality care efficiently. The system would not rely on health plans or insurance companies contracting care for patients. In this system, patients themselves would ‘shop’ for their care, being guided by a system of ‘smart’ copays.
Such a market set-up requires regulation to ensure the desired outcomes: timely, effective, safe, patient-oriented, affordable care. Here, we only discuss the model’s outlines.
Four issues are paramount to such a system. First, equal access to a basic
A healthy health care market: the value index
1 Institute of Health Policy and Management, Erasmus University, Rotterdam Plexus Medical Group, Amsterdam, the Netherlands, 2 Bridges To Excellence, Washington, DC, USA, and 3 Leiderdorp, the Netherlands