Medscape January 14, 2020
Liz Seegert

Larry Kosinski, MD, a gastroenterologist in Chicago, has made most of his income throughout his life through fee-for-service. But he’s been encouraging his colleagues to move from fee-for-service to value-based care since 2012, when he chaired the practice management and economics committee for the American Gastroenterological Association.

However, getting physicians to move to bundled payments from fee-for-service has been challenging. “What you’re fighting in this whole process is an entrenched infrastructure of billing,” he said. “Know why we do the colonoscopies? We get paid for them.”

“Fee-for-service is not dead,” Kosinski said. “This is going to take time. We’re pushing on a glacier. It’s going to take a long time to mold practices and shape them into value-based care.”

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