• DRGs in Europe

    European countries often look to the United States for inspiration and innovation in ways of organizing and paying for health care.

    I know! I can hardly believe it either. But that’s the first sentence of a recent Health Affairs paper that is the subject of my latest post on the AcademyHealth blog.



    • Of course, the major difference is the amounts paid health care providers in the US, far more than the amounts paid in Europe. That’s not to say the European health care sector is suffering, but it’s nothing compared to the enormous amount the US apportions to the health care sector. My friend is a recently retired physician in Scotland, He was paid well but nothing compared to the income of a comparable physician in the US. A big difference, however, is the public pension for the retired Scottish physician, which isn’t that much less than what he was paid while working. In Europe, even physicians place a high value on security. As to Frakt’s post referenced above, I have a small quibble with this statement: “Moving toward bundled, more episodic payments is a goal embodied in the Affordable Care Act, but combining Medicare payments for physicians and hospitals is not.” It’s true that ACA’s incentive, accountable care organizations, wasn’t intended to combine the two components of reimbursement, as ACO’s subsume the continued separation of hospitals and physicians. What’s actually happened, however, is the big trend in integration of hospitals and physician practices (with physicians becoming employees of the hospital), blurring the lines being the two components.