A new survey of healthcare leaders finds that almost all feel the current healthcare payment system is fundamentally flawed and must be reformed. An overwhelming majority favor bonuses for high-quality outcomes and more efficient care.

The current system embraces the fee-for-service philosophy for individual services, including skilled nursing visits, hospital trips and various medical procedures. Ninety-nine percent of respondents favor changing this system, according to the Commonwealth Fund report. As to possible alternatives, 85% said a fundamental provider-payment reform that includes incentives for high-quality and more efficient care would be a good start. A scant majority of respondents-53%–said they felt public reporting of provider quality information would lead to improved performance.

The study, which is the latest in a series of such studies conducted by the Commonwealth Fund in partnership with Modern Healthcare, included more than 200 healthcare leaders and opinion makers from across the country. For full survey results, visit www.commonwealthfund.org.