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The United States healthcare system is experiencing a major shift in delivery and payment policy to address out-of-control spending and low-quality care. In 2010, the Affordable Care Act (ACA) set in motion a new vision for healthcare delivery and reimbursement—value-based care—aimed at replacing the “broken” traditional fee-for-service (FFS) model. Massive change takes time, yet lawmakers and industry experts are determined to fully replace the fee-for-service model, in part, because many believe that the evolution of medicine has antiquated the model, that third-party payers have encouraged overutilization of the model, and that the model has promoted fragmentation for doctors and patients alike.
1. Antiquation (Change phenomenon)
Many experts contend that the advances in modern medicine, the complexities of today’s healthcare system, and the healthcare needs of today’s historic, chronically ill patient population have outdated the capacity of the traditional fee-for service (FFS) model. If true, this “phenomenon of change” argument would certainly suggest that a shift to value-based care may be needed…