Fierce Healthcare April 6, 2021
The Affordable Care Act launched a decade of focus on the move to value-based care, the promise of quality over quantity and a redesigned payment system.
At the center of this has been the primary care doctor and ACOs—the quarterback of the patient experience and the holder of risk, respectively. In a fee-for-service world, which continues to prevail as the predominant methodology for payment, providers are paid for every service provided, regardless of patient outcomes.
Critical components of positive health outcomes are often not reimbursable—for example, ensuring a person has adequate housing, food and community—while components that don’t lead to positive outcomes, like excessive drug screening and testing, are. Primary care doctors, like other clinicians in the system, have to...
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