The government, providers and payers have been striving toward the goal of tying payments to better patient outcomes and more effective treatment to bring down costs. Some providers are hitting the mark while others, especially when required to move to risk-based models, are understandably unwilling to put revenue on the line.
One recent example is accountable care organizations, which have been taking part in shared savings but were recently required by the Centers for Medicare and Medicaid Services to not only get the benefit of savings, but to take on the financial responsibility for repaying losses for not hitting pre-set spending targets. Some balked.
As one healthcare expert said, health systems will tout 50 percent or more of their revenue as being in value-based payments, but as far as what's risk, typically it's in the 2-3 percent range.
But the ship is being turned. Much will be required in integration, data and analytics to get it fully on course. That's why we'll be exploring what works, and what doesn't when it comes to value based care all month long -- so check back here often for the latest updates.
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