NEJM July 31, 2020
Francois de Brantes, MS, MBA, Meredith B. Rosenthal, PhD & Jeroen Struijs, PhD, MSc

While there is broad acceptance of the need for providers to assume financial responsibility for the management of their patients by providing warranties through the implementation of alternative payment models, many of those models fall short in practice because of inherent design flaws.


To accelerate wider adoption of the health care warranty, stakeholders will need to refine the allocation of risk between payer and provider while simultaneously minimizing the real or perceived uncertainty for providers. This must be done through a contract that binds buyer and seller in ways that will align incentives. The authors define a warranty as an implicit acceptance by providers to bear the cost of any complications related to the...