HealthTrust May 17, 2019
More Downside Risk & Greater Physician Input Among Developments for 2019
Prodded by new programs and policies instituted by the Centers for Medicare & Medicaid Services (CMS), increasing numbers of healthcare providers are shifting from fee-for-service reimbursement to value-based care.
“Rates aren’t going to get any higher per unit or per service,” says Jordan
Holland, director at Optum Advisory Services. “Most hospitals we talk to struggle to break even on Medicare, which is problematic considering demographics shifting more toward that federal program. There’s a difficult future ahead if you’re thinking of medical services as a widget and charging a fee for each service.”
Definite themes are emerging among value-based reimbursement models tying payments to quality care achievements. Among the...
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