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End the slow-walk on payment reform.

Merrill Goozner

    Modern Healthcare
    |November 15, 2018
    PubMed
    Summary

    Payment reform initiatives like bundled payments aim to improve financial stability for healthcare providers transitioning from fee-for-service models. These strategies encourage value-based care delivery.

    Area of Science:

    • Health Economics
    • Healthcare Management
    • Policy Analysis

    Background:

    • The healthcare industry is shifting from traditional fee-for-service (FFS) reimbursement.
    • Alternative payment models (APMs) are being implemented to control costs and improve quality.
    • Hospitals and physician practices face challenges in adapting to new financial structures.

    Purpose of the Study:

    • To evaluate the initial impact of payment reform strategies on healthcare provider financial performance.
    • To understand the learning curve associated with adopting bundled payments and global budgets.
    • To assess the feasibility of APMs in moving away from FFS medicine.

    Main Methods:

    • Analysis of financial data from hospitals and physician practices participating in pilot payment reform programs.

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  • Comparative study of financial outcomes between providers under APMs and those under FFS.
  • Qualitative assessment of provider experiences with shared risk and bundled payment arrangements.

    • Main Results:

    • Early adoption of bundled payments and global budgets shows potential for financial adaptation.
    • Providers are beginning to develop financial strategies to align with value-based care.
    • Transitioning away from FFS requires significant operational and financial adjustments.

    Conclusions:

    • Payment reform, including shared risk and bundled payments, represents a necessary evolution in healthcare finance.
    • These models offer a pathway for providers to achieve financial sustainability outside of FFS.
    • Continued monitoring and support are crucial for successful implementation of these reforms.