According to IFEBP (2012), value based healthcare focuses on cost, quality, and outcomes. The most important goal is to remove the barriers and encourage patients to pursue healthy lifestyles that lead to a healthy workforce. It also influences how organizations look at health from a design, wellness, and risk management perspective. This type of healthcare understands that all healthcare is not equal and are trying to find ways to increase quality and decrease cost. In order to make sure patients receive the best care, the value-based system must coordinate and deliver services on a whole person level. The economic principles that are driving the shift from volume-based healthcare to value based healthcare is value for patients, health results
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For instance, the Medicare new payment methodologies include MS-DRG, APC, ASC, Home Health, IP Rehab, and Long-Term care. In addition, many consumers face changes due to the shift from volume to value-based reimbursement because many are beginning to invest in systems that increase the value-based reimbursement (Managed Healthcare Executive, 2015). For instance, the UnitedHealth Group is using the Optum system, a data and analytics and technology solutions company, which allows the UnitedHealth Group to move in the direction of value-based care (Managed Healthcare Executive, 2015). This is similar to Aetna 's Accountable Care Solutions, which provides population health management, technology and health plan services to providers (Managed Healthcare Executive, 2015).Both of these examples have influenced the operational aspect of the reimbursement methodologies. Healthcare is changing rapidly and many consumers have asked providers to shift from volume-based care, fee for service to value based care, which is fee for value (McKesson, 2015). The transition to value based care benefits patients, healthcare providers, and the payer (McKesson, 2015). The structure of the value-based care encourages healthcare providers to deliver the best care to patients at a lower cost (McKesson, 2015). In return, patients will receive quality care at a better …show more content…
Medicare makes separate payments to providers for each of the individual services they furnish to beneficiaries for a single illness or course of treatment (CMS, 2015). This model results in fragmented care with minimal coordination across providers and health care settings. Bundled payments can also align incentives for providers such as hospitals, physicians, and more (CMS, 2015). For example, if a patient has cardiac bypass surgery, rather than making one payment to the hospital, a second payment to the surgeon and a third payment to the anesthesiologist, the payer would combine these payments for the specific episode of care. There a few advantages of the bundled payment model such as quality of care, pricing, transparency and invoicing, coordination and accountability among providers (CarpeVita,
For instance, the Medicare new payment methodologies include MS-DRG, APC, ASC, Home Health, IP Rehab, and Long-Term care. In addition, many consumers face changes due to the shift from volume to value-based reimbursement because many are beginning to invest in systems that increase the value-based reimbursement (Managed Healthcare Executive, 2015). For instance, the UnitedHealth Group is using the Optum system, a data and analytics and technology solutions company, which allows the UnitedHealth Group to move in the direction of value-based care (Managed Healthcare Executive, 2015). This is similar to Aetna 's Accountable Care Solutions, which provides population health management, technology and health plan services to providers (Managed Healthcare Executive, 2015).Both of these examples have influenced the operational aspect of the reimbursement methodologies. Healthcare is changing rapidly and many consumers have asked providers to shift from volume-based care, fee for service to value based care, which is fee for value (McKesson, 2015). The transition to value based care benefits patients, healthcare providers, and the payer (McKesson, 2015). The structure of the value-based care encourages healthcare providers to deliver the best care to patients at a lower cost (McKesson, 2015). In return, patients will receive quality care at a better …show more content…
Medicare makes separate payments to providers for each of the individual services they furnish to beneficiaries for a single illness or course of treatment (CMS, 2015). This model results in fragmented care with minimal coordination across providers and health care settings. Bundled payments can also align incentives for providers such as hospitals, physicians, and more (CMS, 2015). For example, if a patient has cardiac bypass surgery, rather than making one payment to the hospital, a second payment to the surgeon and a third payment to the anesthesiologist, the payer would combine these payments for the specific episode of care. There a few advantages of the bundled payment model such as quality of care, pricing, transparency and invoicing, coordination and accountability among providers (CarpeVita,