There’s little doubt that health care is transitioning from fee-for-service to fee-for-value. Everyone seems to be getting on board: commercial payers are spending billions on risk-based contracts while the Centers for Medicare and Medicaid Services (CMS) is putting its clout behind its accountable care organization (ACO) and other value-based purchasing initiatives.
What’s not clear is how quickly or efficiently this transition will take place. The reality is that for all the progress being made, most health care organizations remain entrenched in fee-for-service. This isn’t surprising since the industry accounts for nearly 20 percent of our nation’s gross domestic product. The journey will take time.
In a series of posts, we’ll highlight the stages through which the transition from fee-for-service to fee-for-value must go. Specifically, we’ll discuss:
- Optimizing financial efficiency by innovating around key areas of the revenue cycle
- Designing a roadmap that plots how organizations will transition from a delivery model of volume-based care to one that is value-based
- Investing in capabilities that will help organizations sustain themselves during the shift
A complete analysis of this transition can be found in our latest white paper The journey from providing care to managing health.
In our next post, we’ll discuss financial needs for transitioning to fee-for-value and how the roles of patient access and medical necessity play a part in the move.