At Geisinger Health System hospitals in Pennsylvania, cardiac patients get a "warranty" with their coronary bypass operations. Unlike traditional hospital billing, in which patients or insurers pay separately for every procedure, the surgery's flat fee includes the bypass operation and any follow-up care necessary for complications.
Hospital executives say the model encourages doctors to provide the best care possible, and has lowered complication rates by at least 20 percent.
Geisinger is also trying other health care innovations -- many of which President Barack Obama has endorsed as part of his health care reform efforts -- such as using electronic medical records and offering performance incentive pay for doctors.
A Geisinger executive and an expert on health payment policy took your questions.
Ronald A. Paulus is executive vice president and chief technology and innovation officer at Geisinger Health System. He holds a medical degree from the University of Pennsylvania and an MBA with a concentration in health care management from the University of Pennsylvania Wharton School. Dr. Paulus is in charge of Geisinger's "warranty" health care program, as well as other clinical innovation, patient engagement and technology transfer programs.
William J. Scanlon is a senior policy adviser with Health Policy R&D. He is also a member of the Medicare Payment Advisory Commission (MedPAC), an independent Congressional agency that advises Congress on issues affecting the Medicare program. Dr. Scanlon was formerly the managing director of health care issues at the U.S. General Accounting Office, and the co-director of the Center for Health Policy Studies and an associate professor in the Department of Family Medicine at Georgetown University. Dr. Scanlon has a Ph.D. in economics from the University of Wisconsin-Madison.