Why Fee For Service Hurts Us: The Plain Language Version

February 27, 2020

I’ve had a few conversations recently with elected state officials, and I’m reminded that speaking plain language always helps. Here goes:

We all agree that fire stations are a good thing, right?

And we agree that we don’t want them to be busy …

So if the firefighters are always watching Three’s Company reruns, that would be good. We still pay for the fire station. We still pay the salaries. Happily.

Therefore – paying firefighters more for fighting more fires would be silly: their financial success would align with hardship in the community.

But this is how we pay medical providers: more sick people = more $$.

We have a social compact: everyone agrees that we should pay for fire stations (infrastructure) and firefighters (humans) to be ready for fires. We all pay for this with our taxes. It’s the most efficient way for us do this.

Shouldn’t we have a social compact that would cause everyone to agree to pay for hospitals and medical offices (infrastructure) and medical providers (humans)? This would be efficient and effective. Then if the medical providers were idle most of the time (watching Three’s Company reruns) – it would be because the community is healthy. Nobody would complain of reduced revenue due to low volumes of emergency department visits. Kinda like what Maryland did. Seems simple. Why not?


Jacob Reider MD, FAAFP
CEO Alliance for Better Health

I am here because I want the world to be more healthy. I have worked for decades to improve the health of our communities through the innovative use of technology, and the promotion of benevolence in business. I am currently CEO of Alliance for Better Health, a New York DSRIP care transformation initiative, Chief Health Officer of Health Coda, and co-founder of RS Partners, a health IT consulting and investing firm.


☀️Good morning Albany! Pre-registering for a vaccine just got even easier😆Simpler to use than ever, we used data about use of the form to simplify & streamline. It now takes less than 2 min to pre reg: http://www.518c19.com https://twitter.com/MCCoyCountyExec/status/1376861676465717250

Payday for two employees who filed qui tam suits against their (fraudulent) former employer.

... yet another example of why fee-for-service is bad for health and bad for care.


We’re partnering w/ Mohawk Ambulance Service for our next pop up vaccine clinic this weekend at Arbor Hill Public Library, Saturday, March 27, 9am-3pm. If you’d like to get vaccinated, please use Albany County’s pre-registration tool at the link below:

Mandatory rule at @alliance_pps all meetings 25 or 50 min (or 15 / 45!) … NEVER 30 or 60 #ZoomMeetingDuration #GiveThemTimeBetween

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