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.


Advice to start-up founders: "Nobody has been thinking as hard about this problem as you have" - @scohen981 ... @definevc

🚨REMINDER: Applications for the Social Care Innovation Fund are due this Friday, July 30! This fund provides investments of $50,000-$150,000 for social care interventions that can measurably improve health and reduce avoidable medical care.

Over the last few weeks, a team of amazing volunteers has created a huge open-source library of over 600 free-to-use icons for healthcare projects. Amazing effort to create a public good for the world. Please share! http://Healthicons.org

Raising money for your company is hard.

I wanted to make it EASIER 💸

I built a database of over 250 ACTIVE ANGEL INVESTORS so you can connect with them.

Want to steal it?

Reply below and I’ll send you a DM 👋🏻

oh...this is 100% free.

RT to share with other founders! 🚀

Alliance for Better Health

You have Successfully Subscribed!