Welcome back, everyone.
In today's health care environment,
organizations and providers
strive to be efficient
with sometimes limited resources.
One way to help support this goal
is to understand current
The healthcare industry
is experiencing a transformation
involving reimbursement payment models.
Currently, there are two models:
fee for service and value-based care.
Let's look at each one individually.
this is the most traditional
Reimbursement is based
on the number of services provided
and payments are made separately
for each one of those.
Now sometimes payments
may be made for services not needed
or may not be based
on current evidence.
In value-based care, clinicians
really consider the quality
and outcomes of care provided.
They strive for efficiency.
They consider best practices.
a holistic team approach to care.
They require coordination
Now let's look at the different types
of value-based payment models.
This is where a primary care physician
leads and coordinates care
between multiple providers
to manage a united care plan for patients
and to ensure efficiency and quality.
Health care providers are incentivized
to meet certain quality
and efficiency benchmark measures.
or episode-of-care payment.
This encourages quality and efficiency
because healthcare providers
are reimbursed with a set amount of money
to pay for a specific episode of care,
such as a hip replacement,
and any complications.
And, finally, shared savings programs.
Physicians form entity groups
and provide population health management.
Quality and efficiency are achieved
through coordinated team care
and any realized net savings
are given back to the provider.
Now let's look at fee-for-service
versus value-based care.
patients face difficulty navigating
a very complicated system alone.
The patients may see multiple doctors,
specialists, and surgeons
who do not communicate
with each other.
And providers lack
the technology and the incentives
to coordinate patient care
across the healthcare continuum.
Now in value-based care,
this rewards physicians
for providing appropriate
that keeps patient populations healthy.
It encourages healthcare providers
to engage with patients.
And finally, it delivers
a connected care experience
where patients receive
more cost-efficient, coordinated,
appropriate, and effective care.
So, remember, value-based care
incentivizes cost efficiency and quality
and create structures that reward
physicians for coordinated, appropriate,
and effective care.
So in thinking about
what we've covered today,
I'd like you to consider this question.
What are four types
of value-based payment models?
They are pay-for coordination,
or episode-of-care payment,
and shared savings programs.
I hope you've enjoyed today's video
on reimbursement models.
Thanks so much for watching.