Patient Safety in Surgery (Apr 2020)

Proposal of a new shared payment model for healthcare financing in the United States: a hypothesis

  • Bruce H. Ziran,
  • E. Kathleen O’Pry

DOI
https://doi.org/10.1186/s13037-020-00242-w
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 8

Abstract

Read online

Abstract The healthcare repayment system in America is highly flawed due to several factors such as uncontrolled costs, unequal access, varied reimbursement systems, and complex patient interfaces. In fact, it is rated the worst among the eleven developed nations analyzed in the Commonwealth Fund’s evaluation conducted every three years. We propose a novel three-tiered model for healthcare repayment designed to fulfill the needs of the patients, the providers, the payers and the nation as a whole. We hypothesized that our new plan may spread cost between multiple entities and offer better coverage and access to care. Our model uses a shared-cost approach wherein the total risk expenditure becomes the responsibility of various stakeholders including the government, insurance industry, hospitals, patients, providers as well as the nation’s economy. While there is no perfect solution to healthcare in America, we believe our three-tiered model can create an economically balanced solution to break deadlock between party lines and result in better outcomes and patient care.