Healthcare payment models

How care is paid for shapes what care is delivered. Fee-for-service rewards activity; capitation rewards keeping a population well and can reward doing less than is needed; bundled payments and pay-for-performance sit between them, each with its own incentive to game. No model is neutral and none has been shown to be generally superior.

We report payment reform with its measurement burden attached, because a model that cannot measure outcomes fairly ends up rewarding whichever outcomes were easiest to count.