Ropes & Gray May 8, 2017
This article highlights key business and legal issues related to value-based healthcare for investors considering opportunities in the healthcare industry.
1. Value-Based Arrangements Are Here to Stay
Value-based healthcare (“VBH”) arrangements are an alternative to traditional volume-based reimbursement methodologies. VBH payment models contemplate payment for healthcare services based on the quality and cost of care as measured against predetermined quality and efficiency metrics, such as clinical quality and outcomes standards, patient satisfaction, care coordination and cost savings and efficiencies (i.e., reduced length of stay, reduced readmissions and improved rehabilitation outcomes).
VBH payment programs have been implemented by both government and commercial payers. The Centers for Medicare and Medicaid Services (“CMS”) and its Center for Medicare and Medicaid Innovation (“CMMI”) shifted...
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