In addition, doctors and hospitals need to move away from fee-for-service medicine so they have further incentives to operate more efficiently and therefore improve their health IT.
Both are radical departures from fee-for-service medicine in that medical care providers are banding together through their practice, clinic or a business umbrella like an ACO to manage populations of patients.
Yet writers in the issue also warn that fee-for-service medicine is not yet dead and it may be here to stay, particularly in the Medicare program where more payment reforms are needed.
With employers unwilling or unable to spend more on medical care and Congress and the White House facing rising deficits and the so-called fiscal cliff, ACOs are becoming an important option over costly fee-for-service medicine.
Whether it is through an accountable care organization (ACO) or bundled payment to a patient-centered medical home, insurance companies and government health programs like Medicare are moving toward so-called value-based payment systems and away from fee-for-service medicine.
And they continue to measure health care against the golden age of fee-for-service medicine, when they could see specialists without the bother of getting a referral from their primary physicians, and when their hapless employers simply picked up the tab.
The clinic is run on a voluntary basis and charges Western clients a fee for consultation and medicine, in order to provide a free service for the Nepalis.