ArticleThe Milbank quarterly2018
Transformation of the Health Care Industry: Curb Your Enthusiasm?
Article in The Milbank quarterly, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed.
- Benefit design and consumer information: results from a randomized trial.The American journal of managed care · 2026Trial
- Increasing Utilization of Advanced Practice Providers in Spine Surgery from 2013 to 2022: A Medicare Part B Analysis.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Financial Management Innovation in Hospital Groups: An Empirical Study of Ophthalmology Specialty Care Under Consolidation.Risk management and healthcare policy · 2026Article
- Health technology assessment infrastructure for emirates health services: a phased framework.Frontiers in health services · 2025Article
- Pay-for-performance programs effectiveness in healthcare: the case of the end-stage renal disease quality incentive program.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Article
- Doctors as Resource Stewards? Translating High-Value, Cost-Conscious Care to the Consulting Room.Health care analysis : HCA : journal of health philosophy and policy · 2022Article
- Effects of affiliation network membership on hospital quality and financial performance.Health services research · 2022Article
- Framework for identification and measurement of spillover effects in policy implementation: intended non-intended targeted non-targeted spillovers (INTENTS).Implementation science communications · 2022Article
- Transformational Change in maternity services in England: a longitudinal qualitative study of a national transformation programme 'Early Adopter'.BMC health services research · 2022Review
- Physician Compensation Arrangements and Financial Performance Incentives in US Health Systems.JAMA health forum · 2022Article
- Structural factors and integrated care interventions: is there a role for economists in the policy debate?The European journal of health economics : HEPAC : health economics in prevention and care · 2021Article
- Impact of a commercial accountable care organization on prescription drugs.Health services research · 2021Article
- Hospital-based health systems 20 years later: A taxonomy for policy research and analysis.Health services research · 2021Article
- A Value-Based Steering Model for Healthcare.Frontiers in health services · 2021Article
- Are health systems redesigning how health care is delivered?Health services research · 2020Article
- Power and Purchasing: Why Strategic Purchasing Fails.The Milbank quarterly · 2020Article
- Organizational diagnostics: a systematic approach to identifying technology and workflow issues in clinical settings.JAMIA open · 2020Article
- Practice Transformation Analytics Dashboard for Clinician Engagement.Annals of family medicine · 2019Article
- Quality measurement and nursing homes: measuring what matters.BMJ quality & safety · 2019Article
- Whose Benchmark Is Right? Validating Venous Thromboembolism Events Between Trauma Registries and Hospital Administrative Databases.Journal of the American College of Surgeons · 2019Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Policy Points: Policymakers seek to transform the US health care system along two dimensions simultaneously: alternative payment models and new models of provider organization. This transformation is supposed to transfer risk to providers and make them more accountable for health care costs and quality. The transformation in payment and provider organization is neither happening quickly nor shifting risk to providers. The impact on health care cost and quality is also weak or nonexistent. In the longer run, decision makers should be prepared to accept the limits on transformation and carefully consider whether to advocate solutions not yet supported by evidence. CONTEXT: There is a widespread belief that the US health care system needs to move "from volume to value." This transformation to value (eg, quality divided by cost) is conceptualized as a two-fold movement: (1) from fee-for-service to alternative payment models; and (2) from solo practice and freestanding hospitals to medical homes, accountable care organizations, large hospital systems, and organized clinics like Kaiser Permanente.
methodsWe evaluate whether this transformation is happening quickly, shifting risk to providers, lowering costs, and improving quality. We draw on recent evidence on provider payment and organization and their effects on cost and quality.
findingsData suggest a low prevalence of provider risk payment models and slow movement toward new payment and organizational models. Evidence suggests the impact of both on cost and quality is weak.
conclusionsWe need to be patient in expecting system improvements from ongoing changes in provider payment and organization. We also may need to look for improvements in other areas of the economy or to accept and accommodate prospects of modest improvements over time.
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