Numerof & Associates September 25, 2024
It’s no secret that the healthcare industry is under growing pressure to reduce the cost of care while improving health outcomes. Linkage of reimbursement to cost and outcomes is the idea behind value-based payment frameworks and is the driving force behind today’s rapidly changing healthcare landscape.
Such linkage will likely be achieved using a population health model. This implies that a provider contracts to deliver designated services to a designated population at an agreed-upon “all-in” price and to meet specific quality targets. The arrangement makes the contracting provider financially accountable for cost overruns and quality shortfalls. The services may be an acute care episode like a knee replacement, or the management of a chronic condition like diabetes. Either way,...
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