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Research ArticlePolicy Forum

A Sea Change in Medicine

Current Shifts in the Delivery and Payment of Medical Care

Richard Bruch
North Carolina Medical Journal July 2016, 77 (4) 261-264; DOI: https://doi.org/10.18043/ncm.77.4.261
Richard Bruch
consultant, Triangle Orthopaedic Associates, P.A.; board chair, North Carolina Specialty Hospital; executive committee member, North Carolina Orthopaedic Association; board of councilors member, American Academy of Orthopaedic Surgery; advocacy committee member, The Ortho Forum. R.B. lives in Durham, North Carolina
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  • For correspondence: rich.bruch@gmail.com
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References

  1. ↵
    Expanded collaboration provides BCBSNC customers with 10–20 percent savings on hip replacement surgeries. Blue Cross and Blue Shield of North Carolina website. http://mediacenter.bcbsnc.com/news/expanded-collaboration-provides-bcbsnc-customers-with-10-20-percent-savings-on-hip-replacement-surgeries. Published February 6, 2014. Accessed February 28, 2016.
  2. ↵
    1. Centers for Medicare & Medicaid Services
    Medicare Program; Comprehensive Care for Joint Replacement Payment Model for Acute Care Hospitals Furnishing Lower Extremity Joint Replacement Services. Published November 24, 2015. Federal Register website. https://www.federalregister.gov/articles/2015/11/24/2015-29438/medicare-program-comprehensive-care-for-joint-replacement-payment-model-for-acute-care-hospitals. Accessed June 19, 2016.
  3. ↵
    1. The Physicians Foundation
    2014 Survey of America's Physicians. Washington, DC: The Physicians Foundation; 2014. http://www.physiciansfoundation.org/uploads/default/2014_Physicians_Foundation_Biennial_Physician_Survey_Report.pdf. Accessed February 28, 2016.
  4. ↵
    Bipartisan Budget Act of 2015. Pub L No. 114-74 §603. https://www.congress.gov/bill/114th-congress/house-bill/1314/text. Accessed June 19, 2016.
  5. ↵
    1. Avalere Health
    Medicare Payment Differentials Across Outpatient Settings of Care. Washington, DC: Avalere Health; 2016. http://www.physiciansadvocacyinstitute.org/Portals/0/assets/doc/Payment-Differentials-Across-Settings.pdf. Accessed February 28, 2016.
  6. ↵
    1. United States Government Accountability Office
    Higher Use of Advanced Imaging Services by Providers Who Self-Refer Costing Medicare Millions. Washington, DC: Government Accountability Office; 2012. http://www.gao.gov/assets/650/648988.pdf. Accessed February 28, 2016.
  7. ↵
    1. Reschovsky J,
    2. White C
    Location, Location, Location: Hospital Outpatient Prices Much Higher than Community Settings for Identical Services. Washington, DC: National Institute for Health Care Reform; 2014. http://www.nihcr.org/Hospital-Outpatient-Prices. Accessed February 28, 2016.
  8. ↵
    1. General Assembly of North Carolina
    Certificate of Need. NCGS § 131E-176. Clause (7a). http://www.ncleg.net/EnactedLegislation/Statutes/HTML/ByArticle/Chapter_131E/Article_9.html. Accessed June 22, 2016.
  9. ↵
    1. The Medicare Payment Advisory Commission
    Report to the Congress: Medicare Payment Policy. Washington, DC: Medicare Payment Advisory Commission; 2015: 115-116. http://www.medpac.gov/documents/reports/chapter-5-ambulatory-surgical-center-services-(march-2015-report).pdf. Accessed June 22, 2016.
  10. ↵
    1. State Health Coordinating Council
    2016 State Medical Facilities Plan. Raleigh, NC: North Carolina Department of Health and Human Services; 2015: 77-88. https://www2.ncdhhs.gov/dhsr/ncsmfp/2016/2016smfp.pdf. Accessed February 28, 2016.
  11. ↵
    1. Tippett R
    Population growth in the Carolinas: projected vs. observed trends. University of North Carolina at Chapel Hill website. http://demography.cpc.unc.edu/2015/12/08/population-growth-in-the-carolinas-projected-vs-observed-trends/. Published December 8, 2015. Accessed February 27, 2016.
  12. ↵
    1. North Carolina Division of Health Service Regulation
    North Carolina State Medical Facilities Plan. North Carolina Department of Health and Human Services website. https://www2.ncdhhs.gov/dhsr/ncsmfp/index.html. Updated January 13, 2015. Accessed February 27, 2016.
  13. ↵
    1. General Assembly of North Carolina
    Amend Certificate of Need Laws. H.B. 200. http://www.ncleg.net/Sessions/2015/Bills/House/PDF/H200v0.pdf. Accessed June 21, 2016.
  14. ↵
    1. French DJ
    Cost savings and justification for changes to CON law. Presented to: North Carolina Legislative Joint Study Committee: Market Based Solutions and Elimination of Anti-Competitive Practices in Health Care; Raleigh, NC; March 18, 2014. http://www.ncleg.net/documentsites/committees/BCCI-6610/March%2018,%202014/Single%20Specialty%20ASC%20Powerpoint%203-18-2014%20final.pdf. Accessed February 29, 2016.
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North Carolina Medical Journal: 77 (4)
North Carolina Medical Journal
Vol. 77, Issue 4
July-August 2016
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A Sea Change in Medicine
Richard Bruch
North Carolina Medical Journal Jul 2016, 77 (4) 261-264; DOI: 10.18043/ncm.77.4.261

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A Sea Change in Medicine
Richard Bruch
North Carolina Medical Journal Jul 2016, 77 (4) 261-264; DOI: 10.18043/ncm.77.4.261
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  • Article
    • Abstract
    • New Payment Models: ACOs and Bundled Payments
    • A Prospective Bundled Payment Plan
    • Medicare and Bundled Payments
    • Comprehensive Care for Joint Replacements
    • Obstacles to Achieving Pay-for-Value
    • Acknowledgments
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