The same way Charles Darwin’s The Origin of the Species addresses the theories behind natural selection, this ebook delves into the idea that Darwin’s theories of evolutionary biology can be applied to the delivery of healthcare.
Providers aren’t getting paid, patients can’t afford their insurance and employers are losing money year after year. It’s time for a paradigm shift where providers who prioritize quality over cost, and value over volume get more patients and get paid faster.
Our current healthcare ecosystem is broken. Fee for service payment methodologies have no sustainability. This ebook analyzes the important stakeholders in healthcare and suggests a free-market solution that leads to value for everyone–patients, providers, and employers.
Direct Contracting and Bundling: Remedies for Rising Health Care Costs?
The disadvantage of fee for service payment methodologies is that providers are systemically motivated to bill for more. This can result in over treatment. Ultimately, fee for service drives increased reimbursement for poorer outcomes. How? Efficient, high-quality providers inherently code for less. One way to combat fee-for-service overpayment is by embracing alternative payment models.
Lessons From the Past Drive Future Innovation for Providers - The “Retailization” of Healthcare
Recently, many healthcare providers have responded with the creation of a “retailized” system. If implemented correctly, the retailization model aims to reduce the cost of healthcare and educate patients nationwide. Although the technological and institutional standards of today’s healthcare system can make it difficult to adopt to a new approach, a proactive perspective to retailization can turn it into a reality sooner than we think.
Since their inception, Bundled Payment methodologies have been met with harsh speculation and criticism. Some health care professionals believe that bundled payments are putting patient health at risk. On the other hand, there are experts who believe that alternative payment models are vital to making health care affordable to all. They see bundled payments as a way of removing barriers to health care and improving cost transparency.
How Large Providers can Prepare for Success with APMs
The U.S. healthcare system is changing and so too are the payment models and methodologies associated with care. In Medicare specifically, there is a movement to replace the current fee-for-service payment model with Alternative Payment Models (APMs) – systems designed to deliver high-quality care at affordable price points.