A Guide to Physician-Focused Alternative Payment Models

RamaOnHealthcare November 3, 2015
AMA and CHQPR

There is widespread agreement that changes in healthcare payment systems are needed to achieve higher quality, more affordable healthcare. To date, however, most payment reform initiatives have had relatively little impact on either healthcare spending or quality. There are two major reasons for this:

1. The most common payment “reforms” for individual physicians and other providers – pay-for-performance, value-based purchasing, and shared savings – don’t fix the real problems in fee-for-service payment systems. Current payment systems don’t pay for many high-value services and they don’t provide adequate payment when care is organized more efficiently. These problems aren’t solved by simply adding “incentives” on top of the existing payment system.
2. Population-based care models such as Accountable Care Organizations can’t succeed unless...

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