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Health inequities in the United States are persistent and pervasive, resulting from well-documented discrimination inside and outside the health system. These inequities are both preventable and treatable.
Reforming how we pay for care is one of the many tools the health system has to improve equity. Yet reform efforts have fallen short and have only recently begun to focus on reducing inequities.
The Status Quo Doesn’t Promote Health Equity
The health system’s historic approach to paying for care — fee-for-service (FFS), in which providers are reimbursed for each service they provide — is designed to treat a patient’s symptoms, instead of promoting long-term health and well-being.
In addition to making care less efficient and more costly, FFS pays less for preventive and primary care services, which are proven to promote equity. As a result, providers are disincentivized from delivering those services and populations who face barriers to care are left worse off.
Reforming how we pay for care through value-based payment (VBP) may offer a solution.