As the Massachusetts legislature considers ways to control health care costs in the state, inequalities in consumer medical spending need to be part of the debate, says HSPH Associate Dean Nancy Turnbull. Writing for WBUR’s CommonHealth blog, Turnbull cites a new report by the state’s Department of Health and Human Services that found greater medical spending among insured individuals who live in zip codes with higher incomes than those in zip codes with lower average income. The reasons for this difference need to be explored in light of a proposal to reform the way health care providers are paid, according to Turnbull. Under the current fee-for-service model, doctors and hospitals are paid for individual tests and procedures. The proposed “global payments” system shifts the emphasis to overall patient outcomes.
Turnbull writes, “if providers that are more likely to take care of higher income people get paid higher prices, and this price disparity is ossified in global payments … we will continue to disproportionately and inappropriately direct medical resources to higher income people, at the expense of lower income people, who actually have higher levels of medical need.”
Health Care for (Almost) Everyone (Harvard Public Health Review)