Finding New Ways
Welch HG, Fisher ES. “Let's Make a Deal: Negotiating a Settlement Between Physicians and Society”. New England Journal of Medicine 1992 October 29; 327(18):1312-15.
Society wants better and cheaper care. Physicians want good incomes, fewer administrative hassles and more joy in work. Although this paper was written three decades ago, the approach that we recommended – drawn from the field of negotiation – suggested that attention to the underlying interests of each “side” could help. The ideas are deeply relevant today.
Wennberg JE, Skinner J, Fisher ES. “Geography and the debate over Medicare reform.” Health Affairs web exclusives. 2002 July-December; Supplement Web Exclusives: W96-114;
What principles should guide health care reform? Make sure patients receive effective care (evidence-based treatments); engage them to ensure that their values guide decisions where preferences matter (preference sensitive care) and address the overuse of supply sensitive care.
Fisher ES, Staiger DO, Bynum, JPW, Gottlieb DJ. “Creating Accountable Care Organizations: The Extended Hospital Medical Staff.” Health Affairs. 2007 Jan-Feb; 26(1):w44-57. Epub 2006 Dec 5.
The article that provided the theoretical and empirical rationale for ACOs. I presented the findings to the Medicare Payment Advisory Commission (MedPAC) and came up with the name “Accountable Care Organizations” with Glenn Hackbarth, the Chair.
Fisher ES. “Building a medical neighborhood for the medical home.” New England Journal of Medicine 2008 Spetember;359(12):1202-5.
The importance of delivery reform to strengthen primary care was captured in the recommendation that everyone should have a medical home. But to be successful, medical homes need to work effectively with the specialists and hospitals also essential to delivering great care – the medical neighborhood.
Fisher ES, Bynum JP, Skinner JS. “Slowing the growth of health care costs--lessons from regional variation.” New England Journal of Medicine 2009 February 26;360(9):849-52.
As relevant as ever. Some US regions spend less than others and payment reform coupled with integrated delivery systems that can manage their capacity (supply) could help the US reduce spending growth and improve care.
Fisher ES, McClellan MB, Bertko JM, Lieberman SM, Lee JJ, Lewis JL, Skinner JS. “Fostering accountable health care: moving forward in Medicare.” Health Affairs (Millwood)2009 March-April; 28(2), w219-31.
This paper offered the theoretical rationale for ACOs and provided empirical estimates of the potential savings to Medicare.
McClellan M, McKethan AN, Lewis JL, Roski J, Fisher ES. “A national strategy to put accountable care into practice.” Health Affairs (Millwood) 2010 May; 29(5); 982-990.
The Affordable Care Act included numerous provisions supporting the transition to payment models intended to reward better care and lower costs. This article suggested how public and private payers, physicians and consumers could move forward together.
Skinner JS, Weinstein JN, Fisher ES. “Withholds to slow Medicare spending: a better deal than cuts.” JAMA 2012 January 4; 307(1), 43-4.
A proposal to slow spending growth by creating powerful incentives for regional collaboration to reduce overuse of supply sensitive services.
Fisher ES, Corrigan J. “Accountable health communities: getting there from here.” JAMA 2014 November 26; 312(20):2093-4.
Nobel Prize winner Elinor Ostrom found that local collaboration to address important public goals was possible and provided a path to overcoming the tragedy of the commons. We applied her ideas to offer frameworks that could be helpful and reviewed potential sources of sustainable financing for such initiatives (such as social impact bonds).
Fisher ES, Lee, P.V., “Toward Lower Costs and Better Care--Averting a Collision between Consumer- and Provider-Focused Reforms”, New England Journal of Medicine 2016 March 10; 374(10): 903-6;
High deductible health plans undermine primary care. As California’s health insurance exchange has shown, it is possible to establish benefit designs that are better aligned with the need for strong primary care and delivery system reform.