RamaOnHealthcare January 10, 2016
CRUNCH NETWORK, Steve Kraus, Andrew Hedin, Andrew Walsh

One of the main tenets of healthcare reform has been to better align payment/reimbursement schemes to incentivize healthcare providers for achieving improved outcomes and lower cost.

Historically, insurance companies (including Medicare) have made separate payments to providers for each of the individual services they provide to patients for a single illness, visit or course of treatment. This payment system, called Fee-For-Service (FFS), incentivizes quantity over quality because a doctor gets paid more when they provide more services.

However, this traditional FFS payment model is experiencing massive disruption due to healthcare reform. The Patient Protection and Affordable Care Act (PPACA) advances new reimbursement models which incent doctors on the quality and cost of a patient episode rather than the quantity of...

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