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JAMA Forum

Sustainable Health Care Reform Requires Changing How Physicians Are Paid

With the passage of the Affordable Care Act, renewed attention is being given to reforming how health care is organized and delivered. But there’s another element needed for sustainable health care reform: finding ways to deal with unsustainable increases in health care spending. And that will require developing a more rational way to reimburse physicians.

Both Medicare and the private sector are engaged in a wide variety of demonstrations and pilot programs designed to encourage greater efficiency and quality in the delivery of care. Many of the early initiatives of the newly created Center for Medicare and Medicaid Innovation (CMMI) within the Center for Medicare & Medicaid Services (CMS) have focused on some aspect of Accountable Care Organizations or the promotion of primary care initiatives.

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