President Biden will face conflict between competition, capitation
President-elect Joe Biden rightly says fighting the pandemic and shoring up insurance coverage will dominate the first six months of his term. But what’s the plan for lowering the cost of care—Americans’ No. 1 pre-pandemic concern?
The incoming administration faces a stark choice. Either it can dramatically expand antitrust enforcement and rely on competition to drive down the exorbitant price Americans pay for care. Or it can vigorously pursue payment reform and aggressively push providers into risk-based payment arrangements where profits depend on delivering better outcomes at lower cost.
To do a little of each guarantees the new administration will fail at both.
A careful reading of the Biden campaign website suggests he leans toward the competition model. On the insurance side, his plan for achieving universal coverage begins with repairing the damage done to the Obamacare exchanges and convincing the last dozen holdout states to expand Medicaid. But he also promised to expand subsidies to make exchange plans more affordable and create a public, Medicare-like option that will be open to everyone, including people in employer-based plans.
On the provider side, Biden promised to deal with predatory pricing policies by stepping up enforcement of the nation’s antitrust laws. His HHS secretary designee, California Attorney General Xavier Becerra, is eminently suited to that task after successfully bringing suit against Sutter Health. He also called for expanded price transparency rules to promote consumer shopping.
Memo to the transition team: This will never work.
No country relies on provider competition and consumer spending decisions to keep healthcare costs in check.
Moreover, promoting competition will only add to the system’s complexity and could create a new class of providers intent on gaming the fee-for-service system.
Sadly, there isn’t a single mention of payment reform on the Biden campaign website. And the head of his healthcare transition team, Chiquita Brooks-Lasure, a managing director at Manatt Phelps & Phillips, focused heavily on Medicaid reform since leaving the Obama administration.
To be fair, value-based payment did come into play in Medicaid as managed-care organizations took over most state plans. But Medicare and the private insurance markets are much bigger players, they pay more for each service, and they face more difficult challenges in pushing payment change on reluctant providers.
Pressure is mounting on the new administration to pay attention to payment reform. It is coming from influential thought leaders connected to both political parties. A team of Democratic Party-oriented strategists recently called for the national scale-up of successful alternative payment models like capitated payments and episode-based bundles.
Another group that included the Bush administration’s CMS head called for better reporting of socio-economic indicators and their relationship to health outcome disparities. Adequate reimbursement based on such measures is a must for safety-net providers to embrace value-based reimbursement.
Meanwhile, some business groups and private insurers are endorsing Biden’s call for a public option with a caveat. It must be run by private insurers willing to jettison fee-for-service medicine. “We need to pay providers, as teams, a predetermined risk-adjusted amount per person per month that provides hospitals and physician organizations with a predictable revenue stream,” according to a piece published in Health Affairs in November; former Kaiser Permanente CEO George Halvorson was lead author.
Systems receiving capitated payments have performed better financially through the pandemic.
Second memo to the Biden team: Set a goal of making capitated payment the rule, not the exception, in American healthcare, whether that payment comes from private insurers or the government.
I’m just commenting to let you be aware of of the exceptional discovery my cousin’s daughter enjoyed going through your blog. She discovered lots of issues, most notably how it is like to have a very effective giving heart to have many more effortlessly fully understand certain extremely tough matters. You really did more than my desires. Many thanks for displaying the helpful, healthy, educational and also easy thoughts on the topic to Gloria.
choloroquine
buy chloroquine online
erectile doctors
erectile dysfunction icd
hydroxychloroquine sulfate 200mg
plaquenil sulfate
does erectile dysfunction pills work
plaquenil and weight loss
tadalafil tablets 10 mg
tadalafil 60 mg for sale
zithromax and uti
order zithromax online
erectile capacity https://erectiledysfunctionpillscvs.com/# does erectile dysfunction end
cheap tadacip fluoxetine 30 mg tablets cialis 5mg online australia kamagra jelly price online fluoxetine 15 mg for sale
vardenafil india sildalis 120 mg order canadian pharmacy prozac generic brand cipro 3 elimite cream over the counter
can you buy female viagra over the counter buy silagra online in india where can you buy prozac ciprofloxacin tablets online sildalis 120 mg
prozac 5 mg daily
loans companies
ivermectin 1 topical cream where to buy sildalis fluoxetine price uk disulfiram coupon cheap generic levitra india
cipro tablet price
emergency loans actual payday loan lenders fast cash installment loans quicken loans careers apply for a personal loan online payday loans for bad credit same day online loans
loans of america cash advance now guaranteed online payday loans i need money now loan board direct payday loan lenders personal loan calculator payment payday loan cash advance instant payday loan
cialis 40 mg generic cipro coupon generic levitra online usa antabuse for sale online sildenafil tablets 100mg price silagra tablet us pharmacy levitra malarex cheap sildalis tadacip uk
my payday loan fast payday loan payday loans direct advance paycheck
prosper loans what is payday loan payday loan without credit check direct payday lenders pay day loans near me
buy cheap kamagra jelly sildenafil viagra cafergot online where can i buy kamagra over the counter sildalis without prescription sildalis 120 mg order usa pharmacy canadian pharmacy levitra 20 mg fluoxetine 20mg capsules price where to buy cialis safely ciprofloxacin 250 mg tablet
can you buy cialis over the counter canada cheap sildenafil from india kamagra oral jelly sachets prozac india how to order levitra online
aralen medicine levitra buy online generic ivermectin cream ciprofloxacin 0.3 fluoxetine 40 mg cost cafergot 100mg genuine cialis online levitra 20 mg price viagra 150 mg online kamagra soft tabs
tadacip paypal
silagra 100 ivermectin pill cost buy kamagra jelly usa buy sildalis 500mg cipro
kamagra oral jelly pattaya cost of cialis 20mg tablets levitra 100 buy tadacip online in india brand viagra order levitra online uk stromectol ebay tadalafil 20 mg online india sildalis 120 mg cafergot tablets buy online
levitra 60 mg
purchase vardenafil
internet payday loans best cash advance loans online
loans online no credit check
credit loan application express loans loans for bad credit
kamagra drug
loans with no credit check online payday loans direct lenders short term loans no credit check loans with low interest
generic cafergot tablets
levitra pills for sale buy generic viagra online australia tadacip 20 tablet generic vardenafil online cheap prozac online sildalis 120
get cash loans in charlotte nc title loan 100 loans bad credit loans australia personal loans with low interest
cheapest generic sildalis cafergot 1 100 mg buy prozac no prescription silagra tablets online kamagra oral jelly for sale in usa
eu pharmacy viagra
missouri payday loans
where to buy tadacip 20 canadian prozac tablet aralen fluoxetine 80 mg capsules cafergot usa stromectol price female viagra cost sildalis online elimite generic kamagra oral jelly price
best personal loans loanme cash loan now personal loans no credit loans with no credit check near me loan with bad credit fast online payday
advance cash loans 5000 bad credit loan payday cash advance secured personal loans payday loan direct long term personal loans
how much is cialis daily use cafergot uk generic levitra 60 mg viagra for women buy fluoxetine 25 mg
payday loans payday loans houston tx best online loans payday loans calculator loans direct payday cash advance paydayloans online lending tree loan
levitra pill ciprofloxacin australia canadian pharmacy tadacip sildalis 120 mg order canadian pharmacy levitra tablet buy online purchase real cialis online buy sildalis online buy kamagra 100mg oral jelly fluoxetine 20mg cost elimite cream directions
ivermectin tablets viagra 100mg online in india buy cipro on line aralen price prescription medication levitra cost of generic cialis in canada medicine fluoxetine 20 mg sildalis tablets cialis price nz kamagra 100mg uk
cheapest generic sildalis 100mg sildenafil price buy prozac online south africa ciprofloxacin 750 mg price buy cheap silagra
online loans instant approval
silagra online india chloroquine uk pharmacy where can i buy cafergot tablets ivermectin for humans cost of 10 mg tadalafil pills
silagra tablets cafegot cheap brand levitra buy sildalis disulfiram online
ordering cafegot vardenafil 20mg price antabuse online uk viagra pills cost in india
vardenafil tablets sildalis tablets cafergot 100mg chloroquine cancer buy viagra online in south africa
cash payday quick cash loans loan interest rates personal loan forms unsecured debt consolidation payday loans no credit check same day
bad credit personal loans
payday loan
advance payday loans online
payday loans in dallas tx direct payday loan lenders loan today loan by phone
cafergot online kamagra super jelly buy cialis for daily use vardenafil generic price sildalis fluoxetine price buy cipro online usa silagra without prescription discount sildalis malaraquin
sildenafil generic without prescription
daily cialis canadian pharmacy
kamagra 100mg oral jelly for women use buy generic cialis online australia buy disulfiram tablets permethrin topical cream over counter buy kamagra online with paypal
interest on a loan same day loans direct deposit payday loans express cash advance loan notes payday advance loans installment loans no credit loans online no credit check advance payday
best personal loans online
loan 500 guaranteed payday loans get cash now loans online payday payday lenders
procardia 10 mg capsule buy generic viagra no prescription viagra tablet 100mg price chloramphenicol prescription levitra from india real viagra 100mg where can you get keflex cialis 300mg tadalafil rx tadalafil buy cheap
tadalafil soft 20
sildenafil generic purchase
canadian pharmacy generic viagra
nitrofurantoin 500mg kamagra oral jelly thailand price apo-prednisone can you buy cipro over the counter mexico ceftin drug female cialis 20mg minocycline medication where can i buy flomax over the counter generic cialis 2019 viagra sildenafil 100mg
canadian family pharmacy sildenafil 100mg online canada discount cialis for sale paypal cialis online minocycline 50
payday advances advance cash america national payday loan
quick loans no credit
cialis 20 mg price in india glucophage best price where can i buy cialis pills pharmacy online uae flomax cr buy tadalafil tablets 20 mg cialis buy australia buy generic viagra canada online otc viagra australia where to buy female viagra pill
guaranteed approval payday loan
purchase viagra over the counter
minocycline for sale ceftin price in india how to buy cialis without prescription generic viagra online best price silagra online
floxin 20 mg prinivil 5 mg tablets prednisone 10mg online buy generic viagra online from india
lipitor 100mg
generic flomax price buy generic viagra india generic for biaxin 400 mg viagra viagra for sale in uk cheap
poor credit loans guaranteed approval online loans instant
direct payday lenders
online med pharmacy
cash loans with no credit no credit loans paydayloans credit builder loans money till payday payday loans maryland loans unsecured
personal loans low interest 24/7 loans money online payday loans bc quality loan service tribal installment loans short term cash denver payday loans loans for good credit 5000 loan with bad credit
loan website payday loan bad credit pay day loans payday loan bad credit installment loans personal loans guaranteed
cardizem price
cialis order uk cost of zovirax sildenafil uk paypal can i buy bystolic online flomax kidney stones pharmacy com silagra 50 floxin cost viagra brand price roxithromycin 150
no fax payday loans payday loans online reviews cash now consumer lending loans usa
sildenafil over the counter canada
price of sildenafil 50 mg silagra online india cialis daily online canada 5mg tadalafil price online pharmacy com
loans guaranteed approval online
loans online no credit check finance plain green loans free payday loan personal loan payments calculator secure payday loans
cheap kamagra for sale uk 100 viagra pill generic cialis daily canada terramycin ointment for dogs sildenafil 100mg price india
loan online instant rapid advance payday loan online online payday loans no credit check payday cash
viagra for sell
glucophage xr 500mg
tadalafil 20mg from india generic viagra online pharmacy uk kamagra jelly price in india viagra australia over the counter online drugstore cialis
advance paycheck loans online direct bad credit loan loans in an hour need cash now payday loans direct
12 mg flomax biaxin medicine how to buy cialis without a prescription plavix 600 canadian pharmacy antibiotics generic tadalafil in canada where i can buy metformin without a prescription drugs foreign pharmacy no prescription viagra online from canada generic kamagra oral jelly for sale australia
money quick emergency loans loan rates today fast payday loan pay day loans payday loan cash advance loan with cosigner installment loans online advance payday loans lendingtree loans
sildenafil price 50 mg cialis 5mg price south africa malarivon discount viagra online canada prazosin for ptsd reliable canadian online pharmacy tadalafil 20 mg soft chewable tablets female viagra india price online sildenafil citrate sildenafil price uk
apply for a loan
generic cialis over the counter
viagra in usa cost of omnicef 300 mg viagra 500 levitra for sale cheap can you purchase cialis over the counter
payday loans 100 approved loan to pay off credit cards best place to get a personal loan same day loans online private lender reputable payday loan companies
personal loans guaranteed approval borrow money fast online loans for bad credit online payday loans direct lenders direct lender installment loans online installment loans cash advance loans
prednisone 14 mg cialis over the counter in usa generic cialis online rx pharmacy viagra omnicef for sinus infection best price viagra 25mg buy cheap kamagra jelly buy viagra online in uk cialis 10mg sale nitrofurantoin 500mg tablet
chloramphenicol for sale
real online payday loans
payday loan cash advance
where to get a personal loan loan now pay day loans near me loans for women installment loans online direct lender stafford loans payday loans same day compare personal loans
cialis online us pharmacy tadalafil 30 generic vardenafil online otc viagra australia tadalafil india price floxin 500g cheap sildenafil tablets 100mg cefadroxil for uti tadalafil online australia flomax online order
simple loan payment emergency cash loan up personal loans with no credit check no credit check payday loans
canadian flomax sildenafil price canada lipitor 80 cheap sildenafil online viagra price singapore
cheap kamagra canada
cialis online price comparison
cash advance america scam easiest payday loan to get bad credit installment loans guaranteed loans on line loans in austin same day personal loans
chicago payday loans
best price cialis 20mg tadalafil 10mg generic price of metformin 850 mg flomax medication kamagra oral jelly amazon buy lipitor 20mg cialis discount prices online vardenafil tablets price online viagra paypal sildenafil 100mg india
chloroquine for malaria terramycin for humans can you buy nitrofurantoin over the counter tadalafil soft tabs lipitor 4 mg ciprofloxacin uk sildenafil otc uk cost of cialis 5mg daily lowest price viagra 100mg discount on cialis
first cash advance
cost of viagra in usa canadian pharmacy viagra no prescription how to get cialis coupon tadalafil 20mg price in usa prednisone pills cheapest sildenafil tablets cialis generic silagra tablets where to buy nitrofurantoin omnicef for uti
chicago payday loans faxless payday loans inbox loan personal loans bad credit installment loans quick loans no credit check
best payday lenders
calan sr 240 mg cheap acyclovir cream canadian generic cialis pharmacy flomax prescription online kamagra 100mg pills
over the counter viagra united states
prazosin tablets in india metformin drug cialis buy online cialis canada online pharmacy no prescription 150 mg generic viagra
payday loans for bad credit payday loan for bad credit specialized loan services bad credit personal loan how do loans work
price for sildenafil 100 mg prednisone purchase canada tadalafil 10mg buy purchase lipitor sildenafil generic 5mg
buy viagra online australia fast delivery
tadalafil india pharmacy kamagra online australia can you buy real viagra online buy ciprofloxacin uk can you buy viagra in australia over the counter tadalafil 5mg online canada lipitor price where to buy women viagra generic viagra soft tabs uk cefadroxil tablets 500 mg
kamagra 100 g gel canadian cialis order sildenafil generic purchase prednisone 20 mg tablet buy viagra online canada paypal ceftin drug buy viagra wholesale tadalafil generic best price sildenafil 58 buy viagra online australia paypal
loan from urgent payday loans loan rate calculator consumer loan payday loans online instant approval
kamagra 100mg oral jelly india price
cash loan payday best debt consolidation loans no doc loans advance payday loans loan 500 online loans bad credit
buy flomax online
kamagra oral jelly 5gm silagra 100 online how can i get viagra online otc viagra pharmacy viagra
payday loans payday loans new orleans loans lenders payday loan guaranteed loan zoom
unsecured loans with bad credit fast cash loan bank loan application personal loans for bad credit guaranteed guaranteed loans small loans best debt consolidation loans approved by bbb
secure payday loans loan options bad credit personal loans guaranteed approval credit consolidation loans for bad credit
buy tetracycline online usa
apo-prednisone viagra 25mg viagra 4 pack generic levitra tablets
prednisone pak
payday loans nj easy installment loans online loan programs private lenders credit card consolidation loan money lending cash loans today
apply for a payday loan online cash advance places need cash now payday loans no credit check direct lender quick money making payday loans america what is a payday loan
cash advance loans
payday loans money facts personal installment loans loans money payday loans express loans great lakes loans small loans for bad credit
how much is 5mg cialis sildenafil tablets 025 retin a where can i buy viagra in south africa viagra 10mg price in india
sublingual viagra
canadian pharmacy diflucan
instant online loans loan las vegas american financial loans discover loans personal loan for bad credit consolidating loans apply online for a loan no credit check loans
loan home bad credit direct lenders direct payday loan
car loans for bad credit borrow money online lenders for bad credit installment buying definition loan for bad credit
personal loans
installment loans for bad credit guaranteed loans for women lenders guaranteed payday loan approval payday loan application need money payday advance loan
viagra tablet 25 mg price super pharmacy can you buy generic viagra accutane cream online viagra best prices sildenafil comparison canadian pharmacy no prescription needed cheap lexapro canada advair pharmacy coupon no prescription viagra canada
buy diflucan over the counter generic vardenafil 20mg otc cost bactrim cheap viagra pills uk synthroid price without insurance non prescription medicine pharmacy order prednisone 10mg buy cialis uk paypal prescription female viagra how to order cialis without a prescription
canadianpharmacymeds diflucan mexico sildenafil 100mg from india dapoxetine 30mg 1mg prednisolone 5mg for sale
payday loans in dayton ohio payday loans no credit check lenders
price for generic viagra can i buy priligy in usa cost of lexapro ivermectin buy uk purchase retin a cream buy deltasone buy viagra using paypal generic viagra 2019 can i buy accutane over the counter generic orlistat canada
multiple payday loans
ivermectin tablets order cialis 100mg for sale 325443009 prednisolone tadalafil 1mg buy viagra gel
bad credit lenders short term loans no credit long term payday loans payday loans without direct deposit fast cash payday loans loans with low monthly payments
buy viagra online mexico
cash advance
payday loans guaranteed acceptance loans payday
[url=https://cashadvc.com/]loans with no credit check[/url]
viagra for women otc
usda loan
methyl prednisolone levitra 20mg pills no prescription prenisone where to buy propecia uk buy 1 viagra pill ivermectin 3 levitra 20mg coupon sildenafil buy usa
cheap cialis uk
plaquenil medicine buy clomid cheap online tadalafil cost india yasmin 3mg best price viagra 50mg
mail order levitra
most reliable canadian pharmacies
http://canadianonlinepharmacykkr.com/
mexican pharmacies online
how much does cialis cost
desyrel brand name
tretinoin gel buy online pharmacy store tops pharmacy buy ivermectin thecanadianpharmacy
rx pharmacy online viagra over the counter levitra price in canada viagra 200mg viagra 20 mg online
neurontin drug medrol 80 generic cialis price comparison low price cialis how to get retin a prescription
generic cialis safe
sildenafil uk otc
online cymbalta ivermectin generic sales viagra online pharmacy uk buying bactrim online how to buy cialis without prescription medrol 16 mg medicine buy malegra fxt viagra best buy ampicillin generic
can you purchase viagra over the counter in canada malegra 100 price clindamycin 500 cialis generic best price canada cheapest generic vardenafil
generic cialis 100mg tadalafil online online pharmacies that use paypal flagyl without prescription viagra 10 pills
arimidex otc
buy clomid in australia canada pharmacy coupon sildenafil cost bupropion 100mg tablets cost online pharmacy delivery delhi tadalafil tab 10mg prednisone over the counter australia canadian pharmacy viagra 50 mg
prescription atenolol 50 mg
canadian 24 hour pharmacy
flagyl prescription online paroxetine 80 mg ciprofloxacin hcl can you buy retin a over the counter uk
legal online pharmacy cymbalta cost canada price of viagra 100mg generic yasmin amoxil buying online levitra 10 maple leaf pharmacy in canada viagra for sale canada
medrol sale zithromax 500mg price in india medication augmentin 875 online pharmacy cialis generic viagra gel 20 mg tadalafil fluoxetine price buy acyclovir 800
clindamycin 300mg glucophage cost generic viagra online for sale
medrol medication generic
nexium 14 tablets
average cost of cialis prescription viagra pill
how much is generic viagra
fluoxetine mexico purchase amoxil 500mg can i buy viagra over the counter australia
generic robaxin 500mg viagra generic canada price sildenafil over the counter us cialis 20mg tablets prices canadian pharmacy 24
website evaluation essay
citalopram for sale uk
canada viagra cytotec for labor induction
clomid 100mg cost
buy tadalafil online cheap
viagra without a doctor
keflex rx
order cheap viagra online
copywriting services writing a good dissertation english research paper
how to get levitra pharmacy mall purchasing viagra albuterol without rx malegra 100 gel
generic cialis cheapest price
provigil prescription uk
paper writing services assignment writing service writing a short speech chapter 5 research paper
buy generic viagra 100mg
tadalafil 20mg cheap
writing a argumentative essay
furosemide drug
online pharmacy store
essay cheats
cialis 20mg price viagra for sale mexico cheapest pharmacy prescription drugs tadalafil order online no prescription trazodone 450 mg
academic writing help
modafinil no prescription
can i buy viagra in mexico
buy generic celexa
viagra online generic
buy viagra online united states
metformin brand name usa
cheap viagra tablets
dexamethasone 8 mg tablets
sildenafil cost uk
tadalafil 10 mg online india
50 mg lisinopril
where to get viagra in canada
brand cialis for sale
tadalafil over the counter australia
tadalafil capsules for sale
cost of generic hydroxychloroquine
generic sildenafil from india
cialis soft tabs 40mg
cialis 5 mg best price usa
fluoxetine 5 mg price
viagra medication online