A Physician Fallow Program To Improve Quality, Safety and Costs

David C. Kibbe and Brian Klepper First published 6/22/11 on the Health Affairs Blog

Copyright ©2011 Health Affairs by Project HOPE – The People-to-People Health Foundation, Inc.

In a recent New York Times op-ed, Rita Redberg MD, a cardiologist and Chief Editor of Archives of Internal Medicine, described the American health system’s penchant for delivering high volumes of “procedures and devices [to] patients who get no benefit and incur risks from them.” The culprit, of course, is fee-for-service reimbursement, used by Medicare, Medicaid and commercial health plans for the past 50 years, which encourages physicians to order more products and services, independent of appropriateness, with few checks and balances. Dr. Redberg notes the estimate by Medicare’s Chief Actuary that as much as 30 percent of Medicare’s expenditures — up to $150 billion/year, or about 9.4 percent of this year’s US budget deficit of $1.6 trillion — provides no value at all to patients. A 2008 PricewaterCoopers study put the waste estimate at nearly 55 percent of total national health care expenditures, a figure that, in 2011, would translate to almost $1.5 trillion, or just a shade under this year’s deficit. Continue reading “A Physician Fallow Program To Improve Quality, Safety and Costs”