Patient-Centered Payment for Care of Chronic Conditions.

Abstract

Current payment systems make it difficult for both specialists and primary care practices to provide all of the services needed by patients with chronic conditions. "Value-based payment" programs have failed to solve these problems. In a patient-centered payment system, there should be 4 separate payments designed specifically to support each of the phases of chronic condition care: (1) Diagnosis Payment, (2) Care Planning Payment, (3) Initial Condition Management Payment, and (4) Monthly Condition Management Payments. Physicians should be accountable for delivering evidence-based services to patients in each phase of care, and payment amounts should be higher for more complex patients.