Word: fees
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...where magicians, monsters, and mimes overtake the streets of Harvard Square in preparation for the subsequent “Monster Mash” block party, featuring games, contests, evening entertainment and maybe even some spooky surprises.Festivities start at 4 p.m., Saturday, October 31, Harvard Square, Brattle Street. No admission fee...
...performance benchmarks. Since 2007, Massachusetts has required all its citizens to have health insurance, about 20% of which involves some kind of global coverage - handling all of a patient's health-care needs for the duration of the policy. In July, the state announced plans to go further, eliminating fee-for-service entirely within five years and mandating global care statewide. Similar plans are ramping up in Minnesota and Wisconsin. "We're going to do this incrementally," says JudyAnn Bigby, Massachusetts' secretary of health and human services. "We want to increase pay-for-performance first and episode payments next...
...health-care bills making their fitful way through Congress include whacks at fee-for-service too, mostly in the form of programs that introduce episode payments or set up what are known as accountable care organizations, community-based teams of doctors who collaborate on care. The programs would be tested first among Medicare patients, but what happens in Medicare - with its 45 million recipients - ultimately drives the industry. (See more about health care...
Finally, there's the matter of the doctors themselves. Physicians may want to get off the fee-for-service carousel, but salary-plus-incentives means that sometimes you won't meet your targets and your paycheck will dwindle. And some docs may chafe at being hitched to a team. One sweetener Dartmouth's Fisher recommends is forgiving some medical-school debts - an idea Obama endorsed at an Oct. 5 photo op with doctors, though in his plan, the break would be limited to those who agree to work in underserved or rural markets...
Overhauling fee-for-service may well make medicine less lucrative for some practitioners. But it would give others a new opportunity to practice medicine in an almost forgotten way: getting to know their patients and keeping them healthy so they can avoid a surgeon or a hospital. "It's a chance for a primary-care doctor to be a hero again," says Dr. Thomas Graf, chairman of Geisinger's community-practice team. That's not the stuff of AA bond ratings or billion-dollar revenue streams, but it just might be worth more than both...