DHA Chief Strategy and Innovation Officer: What are Value-Based Methodologies?

“Value-Based Methodologies include any of a number of alternative payment models (APM) adopted over the past twenty years, including accountable care organizations (ACO), clinically integrated networks, pay-for-performance bonus arrangements (e.g. “collaborative care”), shared savings (e.g., alternative quality contract), bundled payments, centers of excellence (COE), advanced primary care/capitation, provider withholds/ performance guarantees, and others. The common theme with all APM is a desire to move away from traditional fee-for-service (FFS) reimbursement based on the number of procedures performed, typically measured by the number of relative value units (RVUs) a doctor can generate. The RVU was developed by Medicare to determine the level of effort a procedure takes, and therefore how much to pay for physician services, so it conveniently translates into a provider productivity formula. The drawback is that it pays more for higher utilization rather than better care, quality, access, or outcomes…” Read the full article here.

Source: What Are Value-Based Methodologies? – By Ken Yale, September 14, 2020. LinkedIn.



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