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Trustees of Nonprofit Health Care Organizations Whom Do They Serve?

Michael Jellinek, MD1
[+] Author Affiliations
1Lahey Health Community Network, Burlington, Massachusetts
JAMA. 2016;315(16):1699-1700. doi:10.1001/jama.2016.1778.
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This Viewpoint discusses the challenges board of trustee members face regarding the societal benefits and potential financial ramifications of moving from fee-for-service reimbursement to population health management in the United States.

Should trustees, including those serving on boards of nonprofit hospitals, physician organizations, and nonprofit health care organizations, consider every opportunity to transition from fee-for-service reimbursement to population health management and accept financial risk related to possible decreases in the volume of care patients seek at their institutions? For the purposes of this Viewpoint, population health management is a set of activities focused on a defined population that improves quality and outcomes while lowering the total costs of care and is substantially incentivized through contracts that accept financial risk and gain. From 2013 to 2014, health care expenditures increased 5.3%, substantially above the rate of inflation, and equaled 17.5% of all goods and services produced in the United States.1 Fee-for-service reimbursement results in cost increases by encouraging patient use of medical services. The majority of trustees appreciate that the revenue from fee-for-service is essential to keeping their institution financially sustainable.

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