Site-of-Care shifts and payments—A viable strategy to control health care costs?

Site-of-Care shifts and payments—A viable strategy to control health care costs?
JAMA Open Network; Lee A. Fleisher, MD, ML; Sheila P. Burke, RN, MPA; 8/24
The authors sought to determine what proportion of care was currently being performed in hospital-based settings and investigated how much could be shifted to nonhospital settings today and 7 to 10 years in the future with technological advances. They found that the major barriers to site-of-care shifts were economic arrangements, ownership models, and perceived loss of continuity of care at alternative sites. These results affirm their view that to reduce health care spending and protect Medicare trust funds, it will be critical to develop financial incentives and, just as importantly, eliminate financial disincentives to drive care to the safest and lowest-cost site of service.