Commentary on Payment Mechanisms – Dolores Mitchell

Dolores Mitchell, Executive Director, Group Insurance Commission

Purchasers are under enormous pressure to reduce health care costs that increase the cost of their products and services, making companies non competitive and wages stagnant. Purchasers also lack the ability to affect overuse except with tools that often just pass the rising costs to consumers. Utilization review mechanisms breed resentment from employees as well as providers and are only marginally effective. Criticizing doctors or hospitals sis considered taboo,particularly in areas where the medical/pharmaceutical/medical device industries create jobs, even if they have a negative effect on job growth in other sectors of the economy. Purchasers welcome leadership in addressing issues of overuse by physician organizations such as the IOM, THE ABIM and the Lown Foundation.

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