In Reply We agree that differences in fee-for-service reimbursements have incentivized hospitals to grow lucrative service lines that cross-subsidize less lucrative services, such as general medicine, geriatrics, pediatrics, and behavioral health.1 This trend has become especially apparent during the COVID-19 pandemic, as we have previously discussed.2 We also agree with Dr Kornitzer’s suggestion that value-based reimbursement models, if appropriately risk adjusted, may help encourage hospitals to compete on the basis of cost-effectiveness and quality of care rather than on the volume or relative value units of services provided.
Shah S, Navathe AS, Kocher RP. Strategies to Overcome the Market Dominance of Hospitals—Reply. JAMA. 2021;326(3):278–279. doi:10.1001/jama.2021.6895
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