Medicare's central problem is that it institutionalizes the fee-for-service payment system, which rewards providers for the quantity of services provided, regardless of quality, outcome or cost.
But creating a highly efficient network carrier while guaranteeing the quantity of services and territorial coverage sounds a much taller order for any buyer wanting a return on its money.
Delfin Go, the World Bank's lead economist and the report's lead author, said: "Certain health and education outcomes are disappointing, in part because spending has focused largely on increasing the quantity of services, while not paying enough attention to quality".
Lowering payments within Medicare, though, without also reducing the quantity of services provided throughout the health care system ultimately only makes it harder for those on Medicare to find a doctor or hospital willing to treat them, because so many providers stop seeing Medicare patients.
Within this framework, the effects on the quantity of services supplied by the physician has been explored.
Routine data on the quantity of services provided & 12 interviews with NGO and health facility management staff.
A key goal of the Affordable Care Act is to lower healthcare costs by prioritizing the quality of care over the quantity of services provided to patients.
The Patient Protection and Affordable Care Act (PPACA) advances new reimbursement models which incent doctors on the quality and cost of a patient episode rather than the quantity of services provided.
Efficiency is largely driven by the quantity of services produced by physicians but also determined by the approach to measure the inputs and the outputs, as well as other factors that may affect the quantities of outputs produced.
These resources have generally been focused on the quantity of services provided.
