Healthcare in the USA is undergoing a sea change. The move is from a "Fee for service" System to a "Value based Purchasing" plan. Part of the motivation is to reduce costs, part is to improve the outcome of treatment. Most insurance plans are making the shift. Certainly Medicare is embracing the new healthcare model.
Under the old Fee for Service system each visit or test was billed and paid for individually. Some think this incentivized the medical industry to order more medical encounters without regard for results. Value Based Purchasing, on the other hand, pays for service based on outcome and penalizes providers for excessive visits, tests, and poor results. A huge component of value based purchasing is analyzing data to establish protocols of care that save money and ensure positive results for the patient when all is said and done.
A big part of Value Based Purchasing care is patient satisfaction. If you have had much medical treatment lately you have probably been solicited to complete questionnaires with detailed inqueries about every aspect of your treatment from how long you had to wait to see the doctor to how responsive the nursing staff was if you were hospitalized.
The reason there is so much importance placed on readmission rates is that this is one area where financial penalties are pretty stiff. If hospitals can demonstrate a savings in what it costs to treat, say.
a rTSA surgery they are rewarded by sharing a portion of the money saved. If the hospital's cost is higher than Value Based Purchasing thinks it should be, then the facility is penalized.
I know I am not doing a good job of explaining how value based purchasing works. It is very complicated and we are just beginning to make the shift from pay for service healthcare. Certainly time will demonstrate if it is good medicine and cost effective. Let's hope it proves to be both.
Under the old Fee for Service system each visit or test was billed and paid for individually. Some think this incentivized the medical industry to order more medical encounters without regard for results. Value Based Purchasing, on the other hand, pays for service based on outcome and penalizes providers for excessive visits, tests, and poor results. A huge component of value based purchasing is analyzing data to establish protocols of care that save money and ensure positive results for the patient when all is said and done.
A big part of Value Based Purchasing care is patient satisfaction. If you have had much medical treatment lately you have probably been solicited to complete questionnaires with detailed inqueries about every aspect of your treatment from how long you had to wait to see the doctor to how responsive the nursing staff was if you were hospitalized.
The reason there is so much importance placed on readmission rates is that this is one area where financial penalties are pretty stiff. If hospitals can demonstrate a savings in what it costs to treat, say.
a rTSA surgery they are rewarded by sharing a portion of the money saved. If the hospital's cost is higher than Value Based Purchasing thinks it should be, then the facility is penalized.
I know I am not doing a good job of explaining how value based purchasing works. It is very complicated and we are just beginning to make the shift from pay for service healthcare. Certainly time will demonstrate if it is good medicine and cost effective. Let's hope it proves to be both.
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