There are many interesting problems involved in implementing a capitated approach to health care payments, from the internal transfer payments among providers to questions about consumer choice. How can the Commonwealth decide that heading down this path is worth the strife if there is no objective analysis of the main proposal for changing that payment system?
Thus far, we make policy in a vacuum, only hearing from those organizations who have a vested interest in proving that this approach is the right one. In speeches and advertisements, they try to marginalize others who raise concerns.
It is time for Massachusetts to conduct a formal test of the global payment hypothesis.
To scrutinize the efficacy of this form of payment and get guidance for the future, let's have an objective third-party analyze the data to see what has been accomplished to date. I suggest the widely respected Massachusetts Health Quality Partners, but perhaps there is another other qualified group. Let's have an equally well respected group of people, perhaps headed by somebody like Brandeis' Stuart Altman, design the experiment and specify the data needs. Finally, let's have the whole analysis and data be totally open to review by anybody else who wants to look at it and conduct their own analysis. (It is not clear if current studies funded by advocacy groups, like this one, will be open to such review.)
What do we have to lose?