The Shifting Mission of Health Care Delivery Organizations

New payment models reward health care providers for producing outcomes rather than for performing procedures. Drs. Richard Bohmer and Thomas Lee examine the implications of this shift for the mission and operations of health care organizations. An important transition has begun in payment for health care delivery in the United States: organizations that have long been paid for transactions, such as visits or procedures, are beginning — at least in some markets — to be paid instead for producing outcomes. As physicians and hospital leaders contemplate the implications of new payment models, they realize that the transition will be long, difficult, and messy, with major ramifications for providers. After decades of discussion about the problems inherent in fee-for-service medicine, skepticism about whether real change is under way would be understandable. But it would be reckless in . . .