Leadership in Healthcare Payment Reform
The success of modern medicine in combatting disease has been accompanied by increasing complexity that requires a high degree of specialization. Fragmentation and lack of coordination have compromised clinical effectiveness and fostered redundant, potentially harmful care. Dysfunctional financial incentives have exacerbated these problems by inadequately reimbursing providers of coordinated cost-effective care, while often rewarding providers of healthcare services that do little to improve clinical outcomes.
MJP’s unique, component-based healthcare episode infrastructure (patent pending) transforms standard or clinically enhanced claims data into a highly nuanced representation of clinical care. This representation is structured to support sophisticated analyses of comparative risk-adjusted costs and outcomes of care. Results of these analyses are used to set risk-adjusted reference prices for evidence-based required services and bundled individualized services, to evaluate clinical quality, and to determine final payments to healthcare providers. This system provides a comprehensive, integrated, objective, patient-centered method of payment for healthcare services. It respects patient choice and physician autonomy while financially rewarding providers of coordinated cost-effective healthcare.