From Fee-for-Service to Value-Based Payments-Coming to ... · From Fee-for-Service to Value-Based...

1
From Fee-for-Service to Value-Based Payments-Coming to Your Office Soon if Not Already! by Lewis First MD, MS, Editor in Chief, Pediatrics The cost of health care in the United States has been a cause for concern for several decades, yet health care expenditures in a fee-for-serve environment continue to go up. The rising expenditures have led to new payment approaches other than billing for services rendered. The paradigm is rapidly changing to one focused on population health and value-based care-meaning paying clinicians to keep patients healthy and rewarding quality care. One such approach is through accountable care organizations (ACOs). How many of us are in an ACO? Tieder et al. (10.1542/peds.2018-0502) decided to look into this through a survey sent to AAP members in 2016 asking about pediatrician experience with value-based payments through ACOs or other pay-for-quality performance models. 786 of 1,614 pediatricians randomly surveyed responded and 52% of respondents reported they were receiving some type of value-based reimbursement. How excited are our colleagues about moving in this direction? As of 2016, only about a third felt value-based payments would have a positive effect on our ability to improve the quality of the care we deliver; however, more of those receiving payment based on quality felt this approach was better. What do you think about value-based care? Do you agree that it is the right direction for us to go in? If you are getting it, has it improved the quality of your practice and your ability to get adequately reimbursed for the work you and your office or hospital team do? Share with us your thoughts on value-based care by responding to this blog, posting a comment on our website where the article can be found, or simply sharing your ideas on our Facebook or Twitter sites. Guiding Principles for Team-Based Pediatric Care ● Fully Capitated Payment Breakeven Rate for a Mid-Size Pediatric Practice ● Guiding Principles for Managed Care Arrangements for the Health Care of Newborns, Infants, Children, Adolescents, and Young Adults ● Facebook ● Instagram ● Copyright © 2018 American Academy of Pediatrics

Transcript of From Fee-for-Service to Value-Based Payments-Coming to ... · From Fee-for-Service to Value-Based...

Page 1: From Fee-for-Service to Value-Based Payments-Coming to ... · From Fee-for-Service to Value-Based Payments-Coming to Your Office Soon if Not Already! by Lewis First MD, MS, Editor

From Fee-for-Service to Value-Based Payments-Coming to Your OfficeSoon if Not Already!by Lewis First MD, MS, Editor in Chief, Pediatrics

The cost of health care in the United States has been a cause for concern for several decades, yet health careexpenditures in a fee-for-serve environment continue to go up. The rising expenditures have led to new paymentapproaches other than billing for services rendered. The paradigm is rapidly changing to one focused onpopulation health and value-based care-meaning paying clinicians to keep patients healthy and rewardingquality care.  One such approach is through accountable care organizations (ACOs).  How many of us are in anACO?  Tieder et al. (10.1542/peds.2018-0502) decided to look into this through a survey sent to AAP membersin 2016 asking about pediatrician experience with value-based payments through ACOs or other pay-for-qualityperformance models.  786 of 1,614 pediatricians randomly surveyed responded and 52% of respondentsreported they were receiving some type of value-based reimbursement.  How excited are our colleagues aboutmoving in this direction?  As of 2016, only about a third felt value-based payments would have a positive effecton our ability to improve the quality of the care we deliver; however, more of those receiving payment based onquality felt this approach was better.

What do you think about value-based care?  Do you agree that it is the right direction for us to go in? If you aregetting it, has it improved the quality of your practice and your ability to get adequately reimbursed for the workyou and your office or hospital team do?  Share with us your thoughts on value-based care by responding to thisblog, posting a comment on our website where the article can be found, or simply sharing your ideas on ourFacebook or Twitter sites.

Guiding Principles for Team-Based Pediatric Care●

Fully Capitated Payment Breakeven Rate for a Mid-Size Pediatric Practice●

Guiding Principles for Managed Care Arrangements for the Health Care of Newborns, Infants, Children,

Adolescents, and Young Adults

●

Facebook●

Instagram●

Copyright © 2018 American Academy of Pediatrics

https://doi.org/10.1542/peds.2018-0502
http://pediatrics.aappublications.org/content/140/2/e20171489
http://pediatrics.aappublications.org/content/138/2/e20154367
http://pediatrics.aappublications.org/content/132/5/e1452
http://pediatrics.aappublications.org/content/132/5/e1452
facebook.com/aappeds
instagram.com/aap_pediatrics

FOREWORD - Treasury · Web viewbanks already provide savings schemes and therefore have been reluctant to pay the Centrepay fee. Organisations pay DHS a fee for receiving payments

FOREWORD - Treasury · Web viewbanks already provide savings schemes and therefore have been reluctant to pay the Centrepay fee. Organisations pay DHS a fee for receiving payments

How to Read Your Fee Invoice - University of Central …...How to Read Your Fee Invoice Payments, Waivers, Third Party, Aid: This section shows any direct payments (checks by mail,

How to Read Your Fee Invoice - University of Central …...How to Read Your Fee Invoice Payments, Waivers, Third Party, Aid: This section shows any direct payments (checks by mail,

China: Beijing, Xi’an and Shanghai · 2018. 9. 10. · • Automatic Payment Plan (No fee) Payments are taken out monthly or bi-weekly. • Pay in full at enrollment (No fee) Pay

China: Beijing, Xi’an and Shanghai · 2018. 9. 10. · • Automatic Payment Plan (No fee) Payments are taken out monthly or bi-weekly. • Pay in full at enrollment (No fee) Pay

CUSTOMS PROFESSIONAL’S TOOLKIT SHIPPING TO … · completion schedule for 2015). ACH ... Merchandise Processing Fee A fee collected by CBP on most goods ... payments of duty on

CUSTOMS PROFESSIONAL’S TOOLKIT SHIPPING TO … · completion schedule for 2015). ACH ... Merchandise Processing Fee A fee collected by CBP on most goods ... payments of duty on

Insurance and Care NSW | icare - Regulatory requirements ......• introducing gap payments • incentivised payments scheme Vital 1.3 Introducing a ‘fee for outcome’ system that

Insurance and Care NSW | icare - Regulatory requirements ......• introducing gap payments • incentivised payments scheme Vital 1.3 Introducing a ‘fee for outcome’ system that

Medicare Fee-For-Service 2013 Improper Payments Report...The most common cause of improper payments during the 2013 report period (accounting for 56.8 percent of total improper payments)

Medicare Fee-For-Service 2013 Improper Payments Report...The most common cause of improper payments during the 2013 report period (accounting for 56.8 percent of total improper payments)

Schedular Payments - Manawanui · schedular payments to the contractor on your behalf for a small fee. Information for contractors If you receive income as a contractor (not salary

Schedular Payments - Manawanui · schedular payments to the contractor on your behalf for a small fee. Information for contractors If you receive income as a contractor (not salary

Electronic Filing and Service of Documents - Online Fee Payments · Electronic Filing and Service of Documents - Online Fee Payments Introduction Filing users are required to electronically

Electronic Filing and Service of Documents - Online Fee Payments · Electronic Filing and Service of Documents - Online Fee Payments Introduction Filing users are required to electronically

Reference Guide Reference Guide as of 8/01/2012 1 ... • Processing management fee payments ... 12 Fee Choice Agreement X

Reference Guide Reference Guide as of 8/01/2012 1 ... • Processing management fee payments ... 12 Fee Choice Agreement X

World Explorers - Amazon Web Services...Spread payments over time! Lock in your child’s place now with an enrollment fee, and spread the payments over four installments starting

World Explorers - Amazon Web Services...Spread payments over time! Lock in your child’s place now with an enrollment fee, and spread the payments over four installments starting

...Flex and Fit Membership: 12 monthly payments of £220 plus initial joining fee of £370 Tennis Membership: Annual payment of £635 plus initial joining fee of £185 Please contact

...Flex and Fit Membership: 12 monthly payments of £220 plus initial joining fee of £370 Tennis Membership: Annual payment of £635 plus initial joining fee of £185 Please contact

Alternatives to Fee-for-Service Payments in Health … Center for American Progress | Alternatives to Fee-for-Service Payments in Health Care Introduction and summary Our nation’s

Alternatives to Fee-for-Service Payments in Health … Center for American Progress | Alternatives to Fee-for-Service Payments in Health Care Introduction and summary Our nation’s

CEM CATBAS, DIRECTOR files/Baltimore... · Performance fee: $100 for The Nutcracker, and Costume fee: $100 for Spring Performance. A $15 Late Fee per week will be assessed for payments

CEM CATBAS, DIRECTOR files/Baltimore... · Performance fee: $100 for The Nutcracker, and Costume fee: $100 for Spring Performance. A $15 Late Fee per week will be assessed for payments

2017NIC Spring Investment Forum · Medicare Fee-for-Service Payments Linked to Quality or Value 5% 20 6 Medicare Payments Now Tied to Alternative Payment Models Accountable Care Organizations

2017NIC Spring Investment Forum · Medicare Fee-for-Service Payments Linked to Quality or Value 5% 20 6 Medicare Payments Now Tied to Alternative Payment Models Accountable Care Organizations

MAYNILAD - JICAMaynilad’s concession fee payments were higher than the generated revenues. By end-2000, Maynilad’s revenues rose just enough to equal roughly the concession fee

MAYNILAD - JICAMaynilad’s concession fee payments were higher than the generated revenues. By end-2000, Maynilad’s revenues rose just enough to equal roughly the concession fee

Medicare Fee-For-Service 2014 Improper Payments Report · 1 Medicare Fee-For-Service 2014 Improper Payments Report EXECUTIVE SUMMARY 87.3 Percent Accuracy Rate The estimated 20141

Medicare Fee-For-Service 2014 Improper Payments Report · 1 Medicare Fee-For-Service 2014 Improper Payments Report EXECUTIVE SUMMARY 87.3 Percent Accuracy Rate The estimated 20141

My Massanutten...MY MASSANUTTEN | EDITION: FALL 20202 INSIDE THIS EDITION Maintenance Fee Payments 540 .289.4904 option 1 Reservations 540 .289.4904 option 2 Mortgage Payments 434

My Massanutten...MY MASSANUTTEN | EDITION: FALL 20202 INSIDE THIS EDITION Maintenance Fee Payments 540 .289.4904 option 1 Reservations 540 .289.4904 option 2 Mortgage Payments 434

Compensation Models in Home Health · Compensation Models, NAHC 10/14 3 FLSA: “Fee Basis” Payment “…these payments in a sense resemble piece work payments with the important

Compensation Models in Home Health · Compensation Models, NAHC 10/14 3 FLSA: “Fee Basis” Payment “…these payments in a sense resemble piece work payments with the important

Credit Card Payments CC INFO.pdf · 2021. 1. 11. · Credit Card Payments Processed by Judicial Innovations 4% Convenience Fee Judicial Innovations accepts all major credit cards,

Credit Card Payments CC INFO.pdf · 2021. 1. 11. · Credit Card Payments Processed by Judicial Innovations 4% Convenience Fee Judicial Innovations accepts all major credit cards,

Moving from Fee For Service to Value Based Payments

Moving from Fee For Service to Value Based Payments