How to get started with risk-based payment models

Value-based care is becoming increasingly popular with payers because it reimburses for outcomes rather than services putting a greater focus on the long-term health of the insured. Physicians have been slow to move away from traditional fee-for-service, but there are growing cost pressures in health care to reduce spending and payers see value-based care as the best method to address the issue. In order to entice more physicians to make the jump to value-based contracts, payers will often offer risk-adjusted models where the physician assumes some of the financial risk, but also shares in the savings. If a practice is efficient and invests in preventive care for its patients, revenue and profit can be increased, but only if the right investments are made in technology and tracking. Medical Economics spoke with Patrick Sulzburger, CPA, owner of Coding and Compliance Initiatives, about the pros and cons of risk-adjusted payment models and what a practice needs to do to be successful with them.