From Volume To Value: Achieving Bold Change In Our Healthcare Payment Systems (Forbes)

FORBES | One question I hear repeatedly as I travel the country discussing healthcare is whether the transition from fee-for-service to value-based care can really be done in a way that lowers cost and improves patient care. The answer is: it can.

While there isn’t a one-size-fits-all solution, successful systems change requires the collaboration and coordination of payers, providers, physicians, regulators, and patient-consumers, taking them outside their comfort zone by flipping the current incentive structure on its head.

It’s useful to review why we should change the way we pay for our healthcare in the first place. The current, dominant fee-for-service (FFS) model incentivizes over-provision of services, which contributes nothing to improving health. Physicians are paid for each medical test they run, but they aren’t compensated for coordinating patient care among different providers, or spending time on patient education. There isn’t a billing code for that. As a result, care is fragmented and disjointed, leading to inefficient delivery and wasteful duplication of services. A patient feels overwhelmed by the care labyrinth he or she must navigate. One estimate put the overtreatment cost alone at $192 billion in 2011.

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