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The transition from a fee-for-service healthcare model to value-based care (VBC) in the U.S. has continued to gain momentum in the wake of the Covid-19 pandemic. That’s because providers operating on a fee-for-service basis saw revenue fall sharply through much of last year as elective procedures were cancelled and many patients delayed primary care, even for chronic conditions. Quite simply, under the traditional healthcare payment model, no service equals no pay.
In contrast, those providers with risk-based contracts were paid a specific amount, either per member or per patient, regardless of whether that patient received healthcare services. It doesn’t take a CFO to recognize that something is better than nothing. Nor does it take the Surgeon General to know that a reimbursement model which rewards providers for delivering quality care while controlling costs will produce better outcomes for patients, providers and payers. That is the promise of VBC and risk-based payment models.