The
American health industry has recently shifted from a fee-for-service
(FFS) model to the payment model that reimburses and rewards
physicians for taking a holistic approach to care. The new
reimbursement model is known as “value-based care” or
“free-for-value.” It aims to eliminate the FSS model which
involves charging the insurers and patients solely on the number of
procedures or treatments performed.
Value-Based
Care Vs Fee-For-Service—what
are the key differences in each of these systems? What is the origin
of value-based care? The aim of this post is to help the US
healthcare professionals, medical coders, and billers to know
everything about the two models with the transition in full swing.
What Is Value-Based Care?
American
healthcare professionals are reimbursed with incentives/ payments for
taking a holistic approach to care at a low cost. This system is
known as the value-based care system in the US, which demands that
clinicians use best practices while treating patients. This payment
model compels the doctors to prioritize the quality of care provided
to patients. In this philosophy of care, doctors focus on the
quality, efficiency, and overall outcome of care and are paid
accordingly.
When
successful, the paying for performance further motivates the
healthcare team to intentionally consider providing quality care at a
low cost and to improve the patient’s healthcare outcomes. Thus,
the value-based care model encourages effective coordination and
communication among physicians across specialties.
What Is Fee-for-service?
Fee-for-service
or FFS is the healthcare payment model where physicians and
clinicians are paid based on the number of services, treatments, and
procedures that they provide to patients. In this healthcare model,
medical professionals are compensated by government agencies and
insurance companies every time patients have appointments/surgical
consultations/hospital stays. Healthcare professionals are reimbursed
regardless of whether the outcome of the test or procedures is
positive or negative. FFS is the traditional payment model that
unbundles the medical services involved to pay separately for each
service availed.
Read
more on Fee
For Value Over Fee For Service
