An avalanche of unnecessary medical care is harming patients physically and financially, writes Atul Gawande in The New Yorker (May 11, 2015). "Unnecessary care often crowds out necessary care," says Dr. Gawande, "particularly when necessary care is less remunerative." What we need to do, he suggests, is financially incent primary care to prevent unnecessary care and, when high-cost episodes do occur, insist on value. These strategies are the foundation of Ohio's effort to reset the basic rules of health care competition to reward better care instead of more care. In March, Ohio's four largest health insurers (Anthem, Aetna, Medical Mutual and UnitedHealthcare) joined Ohio's five Medicaid managed care plans to report performance data to providers of six high-cost episodes of care. These plans also are working together to financially support access to patient-centered primary care medical homes statewide.
Example performance report