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The State of Value-Based Reimbursement, Financial Risk in Healthcare

The State of Value-Based Reimbursement, Financial Risk in Healthcare

December 22, 2021Jacqueline LaPointeRevCycle IntelligenceRisk Management

Most healthcare payments made in 2020 were tied in some way to value or quality of care, according to the latest data from the Health Care Payment Learning & Action Network (LAN).

The LAN’s latest APM Measurement report showed that 40.9 percent of US healthcare payments, representing approximately 238.8 million Americans and over 80 percent of the covered population, stemmed from value-based reimbursement models last year. These models included upside and downside risk arrangements, as well as population-based payments.

Additionally, almost a fifth (19.8 percent) of all healthcare payments made last year were in some way tied to value or quality of care while still being based in fee-for-service. The remaining 39.3 percent of payments were strictly fee-for-service.  

While the healthcare industry has reached a tipping point with value-based reimbursement adoption, it has taken a while to get there. And progress has especially been slow over the last two years as providers combat COVID-19.

But value-based reimbursement adoption has been quicker in some parts of the healthcare system compared to others.

Full Article

: FFS

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