The healthcare industry is ever-changing, and one of the most recent developments has been the push towards value-based care. As opposed to a fee-for-service model, value-based care emphasizes quality rather than quantity. Read on to learn more:
What is it?
Value-based care is a type of reimbursement that gives healthcare providers incentives based on the quality of care. It rewards doctors and healthcare institutions who reduce readmission rates, offer quality preventative care, and use certified technologies in their practice. All of this improves care for individuals while also reducing overall healthcare costs.
Value-based vs. Fee-for-service care
Fee-for-service care is the traditional reimbursement model. It is as it sounds—it reimburses institutions for the number of services it provides. So, the more tests and procedures that an institution offers, as well as the more patients that they treat, then the more they are reimbursed. However, the problem with this model is that it incentivizes quantity rather than quality. It focuses more on the bottom line rather than on the welfare of a patient.
How does it work?
Switching to a value-based program means that a healthcare institution will be judged based on the quality and cost of the care that they provide. The Centers for Medicare & Medicaid Services (CMS) will evaluate and score institutions based on data concerning their readmission rates, preventative care, and technologies. For example, a physician’s office with higher immunization rates will have a better score than one with lower immunization rates. Then, using these scores, the CMS will calculate how much they are reimbursed.