We are beginning to see another form of reimbursement that could potentially replace the previous payment model. This new alternative is attractive to many because it should, in theory, promote better quality health care services to patients. There are considerable differences between the two strategies and only time will tell which concept is superior. Here is a brief comparison between the older fee-for-service concept and the newer value-based payment models.
Many consider and label this model as being outdated based on its principles. In fee-for-service, physicians get paid based on the number of services they perform. By being paid in volume, it incentivizes health care providers to have as many patients as possible. In addition, they benefit from conducting more procedures and testing in their offices. A major downfall to this concept is that there is no reward for providing high-quality services to patients. This sad reality does not sit well with many people. This concept mainly incentives physicians to treat their practice’s as assembly lines to obtain more earnings. By doing so, puts physicians in a time crunch because they still had to process all the patients’ claims. Also, in this model services rates are unbundled. In other words, every single service that is provided is required to be paid for separately. This is not ideal in terms of efficiency and has been causing health care providers all kinds of trouble.
The federal government wanted a way to decrease healthcare costs. Value-based efforts are seen as the long-term goal in medicine because of their ability to reduce costs and to standardize the best practices in the healthcare industry. This will allow health care providers to know ahead of time what actions they should expect to be successful. This makes for a better overall experience and results for patients. Electronic medical records are also available that do way with unnecessary procedures and testing. Through this strategy, less time and energy wasted on treating patients. Not only does value-based programs achieve this but they also improve quality of care to patients. Under this concept, payments to providers are given based upon the value of care they give. Also, payments are bundled for patients. They do not need to pay for every single service or test individually.
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