Precisely the problem today:
Ironically, providers incentives to undertreat due to health plan reimbursement rules and structures coexist with incentives to overtreat, compounding the problems for patient value. Incentives to overtreat have four sources. First, physicians and hospitals get paid to treat, not for keeping patients healthy. Second, when reimbursements are squeezed, the incentive to treat more becomes stronger. Third, the phenomenon of “supply driven demand” (more specialist = more specialty care provided). Fourth, physicians will provide as much care as possible out of several obligations to “do something”, increase patient satisfaction, and reduce the risk of malpractice claims (overtest, overtreat, overrefer).The net result of the simultaneous incentive to overtreat and undertreat is poor quality and poor value.
