Fee for service | VBCExhibitHall Library

A Decade of Value-Based Payment: Lessons Learned And Implications For The Center For Medicare And Medicaid Innovation, Part 1

June 9, 2021Garrett SchmittNo CommentsACOs, APMs, CMS, Cost Reduction, COVID-19, Fee for service, health spending, organization of care, payment, payment models, value-based payment, value-based purchasing, vbc

Over the past decade, adoption of value-based payment (VBP) models has increased substantially. The Center for Medicare and Medicaid Innovation’s has launched multiple new models since its authorization, commercial payers have structured almost one-third of their payments as alternative payment models (APMs), and state Medicaid programs have increasingly included payment reforms in their waivers and…

Value-Based Contracting 101: Preparing, Negotiating, and Succeeding

June 1, 2021Garrett SchmittNo Commentscontracting, Fee for service, MSSP, negotiating, negotiations, Next Generation ACOs, payer-provider collaboration, Payers, Physician Engagement, Value based contracts, value-based care

The Triple Aim. The Quadruple Aim. Right care at the right place at the right time. Whether one works in a hospital or small independent practice, healthcare providers are leaning on these concepts to deliver valuable care to their patients, and that is in its simplest form: care that results in the best patient outcomes…

New ACO Playbook: Three Touchstones For ACO Viability

May 13, 2021Garrett SchmittNo CommentsACOs, alternative payment models, community, coordination of care, Data, Fee for service, growth orientation, Hospital led ACOs, Medicare ACOs, MSSPs, physician-led ACOs, Primary Care First, Risk, technology, vbc

Some believe that an ACO’s leadership structure predicts its success. They point to differing savings results for physician-led versus hospital-led ACO shared savings models (MSSPs) to make their case. In particular, they make the argument that future Value-Based Care (VBC) policies should benefit the growth of successful physician-led ACOs, protecting them from policies that force…

Population health still at odds with fee-for-service

April 6, 2021Garrett SchmittNo CommentsFee for service, FFS, SNFs

Year after year, surveys show the same thing: Healthcare providers’ evolution toward accepting risk to keep patients healthy—widely viewed as the holy grail of lowering healthcare costs—has been painfully slow. So long as that’s the case, experts say the financial returns providers can expect to draw from population health management, where they gather patient data…

Family doctor, employer groups join forces to replace fee-for-service

July 15, 2020Garrett SchmittNo CommentsFee for service, FFS, medical advantage, Primary Care

A national primary-care physician association and an employer group have teamed up to develop a care model that aims to shift away from fee-for-service reimbursement. The American Academy of Family Physicians and National Alliance of Healthcare Purchaser Coalitions plan to leverage regional employer coalitions and physician networks to form a national primary-care model based on…

Can PCPs Survive COVID-19? Only If Fee-for-Service Goes

May 21, 2020Garrett SchmittNo CommentsFee for service, FFS

Primary care practices need new ways of being paid if they are going to survive and thrive in the wake of the COVID-19 pandemic, several speakers said Wednesday during a webinar hosted by the Alliance for Health Policy. “Fee-for-service is simply not a system this is conducive or amendable to primary care being able to thrive…

Could coronavirus derail the decades-long shift to value-based care?

April 15, 2020Garrett SchmittNo CommentsFee for service, FFS

As the coronavirus sickens tens of thousands of Americans while pressuring the bottom lines of medical providers, analysts worry the pandemic could also hit pause on the decades-long march toward value-based care, as hospitals and doctors look to recoup revenue in the short-term instead of putting more dollars at risk. Massive health systems and independent physician offices alike…

The Administrative Benefits of Value-Based Care

January 4, 2020Garrett SchmittNo CommentsBundled Payments, Bundles, Fee for service

Healthcare is not only expensive, unfortunately, it’s also wasteful. In fact, nearly $760 billion annually is spent unnecessarily in healthcare, according to a recent study published in JAMA. In addition to identifying the problems within healthcare, the researchers of the JAMA study also suggested methods of addressing waste. One such solution is greater adoption of value-based payment programs. Primarily…

New Marketplace Survey: Transitioning Payment Models: Fee-for-Service to Value-Based Care

November 8, 2018Garrett SchmittNo CommentsFee for service, FFS

In a survey of the NEJM Catalyst Insights Council in July 2018, sponsored by Optum, 42% of respondents say they think value-based reimbursement models will be the primary revenue model for U.S. health care. Indeed, this transition is already happening. Respondents report that a quarter of reimbursement at their organizations is based on value, on…

Payers reveal effects of value-based care strategies: 6 study findings

June 18, 2018Garrett SchmittNo CommentsFee for service, Payers, VBHC

Value-based care has resulted in medical cost savings, investments from commercial lines of business and an accelerated decline in fee-for-service, according to a Change Healthcare national research study. The study, conducted by ORC International in April and commissioned by Change Healthcare, included a survey of 120 managed Medicare, managed Medicaid and commercially focused payers. Here…