In recent years, all of the discussions surrounding the topic of health care payment reforms focus heavily on the transition that comes from going from a reimbursement for fee-for-services model to a model that focuses on reimbursements that are value-based.

Payment Reform

This model is often referred to as the “VBR Model”. Currently, the value-based reimbursement option is the requirement in the United States because it not only provides more positive outcomes for patients, but, it offers incentives for both medical providers and the members that are part of the model. The fee-for-service model often puts medical providers getting paid more for services rendered that are not necessary.

While this is good for the bank accounts of those providers, it is resulting in uncontrollable and excessive expenses in health care.

Keeping the Focus on Patient Care

The real difference in value-based reimbursement models is not the alternate payment methodology, but keeping the focus on patient care. While many consider this payment strategy to be disruptive, it is one that makes healthcare providers do what they started out to do when they started their career – keeping patients at their healthiest.

The most positive outcome experienced is better healthcare at lower fees. Spending is controlled.

Immediately after this positive outcome is the fact that the VBR model is not controlled by politics. Now, patients will only have to endure testing, treatments, and diagnostic tools that are absolutely necessary for their particular medical conditions. This means far fewer unnecessary costs.

Basic Statistics and Facts

The following outlines a few basic statistics and facts that surround the changes in payment reform:

  • The payers of such systems are about 58% of the way towards practicing in total value-based reimbursements within their practice.
  • 74% of all of the insurers are reporting a positive change and improvements when it comes to patient outcomes.
  • 61% of all active insurers believe that the value-based reimbursement model will result in a highly lucrative financial impact.
  • 45% of the money from United Health Group is based on the ever-popular VBR model.
  • 63% of the membership of Humana is based on value-based care.
  • Anthem plans to have 50% of their payments tied into the VBR model by the year of 2018.

As you can see, the value-based reimbursement payment model is quickly gaining in popularity and momentum. If you would like to get onboard, PRIME by the Colorado Physical Therapy Network is the way to go! This special network is designed to keep up with the rapidly evolving healthcare market.

It is becoming a necessity to become involved in a large delivery care system. If your practice is not involved now, time is of the essence. Once the opportunity is gone, it is gone.

This is a Management Service Organization (MSO) that allows you to retain control of your practice while enjoying the benefits of a powerful network. If you would like more information on value-based reimbursements, the PRIME network, or similar topics, visit us today at the following link:

You Might Also Like