
@ShahidNShah
Value-based care is a breakthrough, which aims to reduce health-care costs while improving quality and outcomes. It will eventually affect every patient in the country. However, not everyone is on board yet, because part of the value-based equation includes hospitals being paid less to provide better care. That is a significant challenge, but one that Cleveland Clinic sees as an opportunity to improve. Others must do the same.The Affordable Care Act includes a provision to change the way hospitals are paid, shifting from a reimbursement model that rewards procedures to one that rewards quality and outcomes. It will no longer be about how many patients you can see, how many tests and procedures you can order, or how much you can charge for these things in health care. Instead, it will be about costs and patient outcomes, such as faster recoveries, fewer readmissions, lower infection rates, and fewer medical errors. In other words, it will come down to price. That’s a good thing.
A value-based healthcare model differs significantly from the more traditional fee-for-service (FFS) model. Healthcare providers are compensated based on the amount, or quantity, of services delivered under the FFS model. 2 Office visits, tests, procedures, and other treatments are examples of these services. For each service that clinicians provide, reimbursement rates are established.Healthcare providers have a number of reimbursement options when transitioning from fee-for-service to value-based care. CMS has developed several different reimbursement models, and commercial payers have followed suit with their own variations and models.
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When acute care providers look at hospital readmissions, it is natural to think about what is being done once the patient is discharged. However, what many forget is that a large portion of patients …
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