An Introduction to Value-Based Payment Models
Pearl | November 30, 2016 | Payers, Healthcare Reform, Pearls, Population Health, Practice Models
By Susanne Madden
Originally published at: www.physicianspractice.com
For many physicians and practices, their introduction to “value based” contracts will come in the form of understanding Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). However, if you are getting paid on a “pay for performance” basis from the commercial payers, you are already participating in value-based contracts.
The “value-based purchasing” model evolved from work done by the University of Michigan Center for Value-Based Insurance Design, a non-profit that was established in 2005 to develop, evaluate, and promote value-based insurance initiatives. Their initial research studied the impact of healthcare costs and paying for care “events,” rather than outcomes. Eventually value-based reform helped to shape the Patient Protection and Affordable Care Act (the ACA) signed into law in 2010.
So what does all that mean to you? The bottom line is that “payers” — insurance companies, employers, and now consumers themselves — are looking for more value for the money they spend on healthcare.