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Pricing and paying for proactive care.
1scottmacstra@earthlink.net
Summary
New healthcare payment models are emerging as third parties increasingly fund proactive health services. Common innovations include pay-for-performance bonuses and gainsharing arrangements.
Area of Science:
- Healthcare Economics
- Health Services Research
Background:
- Proactive health services are increasingly funded by third-party payers.
- This shift necessitates new approaches to healthcare pricing and reimbursement.
Purpose of the Study:
- To identify and describe emerging pricing strategies for proactive health services.
- To highlight novel financial incentives being adopted by healthcare payers.
Main Methods:
- Review of current trends in healthcare reimbursement.
- Identification of common alternative payment models.
Main Results:
- Emergence of new pricing bases and types for proactive care.
- Increased adoption of pay-for-performance bonuses.
- Bonuses tied to achieving specific disease or risk outcomes.
- Implementation of gainsharing arrangements.
Conclusions:
- Third-party payment for proactive health services is driving innovative pricing models.
- Performance-based bonuses and gainsharing represent key shifts in healthcare finance.
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