Population health and fee-for-service are not a rigid dichotomy. Treating them as such misses a major opportunity for healthcare executives looking to advance strategies to protect fee-for-service payments and volumes from eroding while preparing for the eventuality of a greater share of revenue coming from risk. I should know. At my organization, I am the…
Value-Based Reimbursement—once focused on incentives and shared savings—now more often means capitation. Whether adopting Medicare Alternative Payment Models (APMs) or contracting with health plans, physician groups and health systems have signaled greater willingness to adopt these new Risk payment models with their guaranteed payments for attributed patients. But here’s the problem: If you don’t have good data…
The challenges of lowering care costs and improving healthcare quality may lead payers to consider the use of capitated payments as part of their value-based payment model strategies. Capitated payments are pre-arranged payments for healthcare providers to deliver services on a per member per month (PMPM) basis. Providers are paid a set amount for each…