Capitation, as a value-based payment model, has been around for decades. Many of us have experimented with variations of capitation, ranging from full capitation for all healthcare services to specialist capitation, to primary care (PCP) capitation. Currently, Primary Care Clinicians are much more comfortable with the nuances of these models because of the expansion of Medicare Advantage. This… Read More »
Bundled payments for episodes of services such as joint replacements are not a new concept. Throughout the years, the Centers for Medicare & Medicaid Services (CMS) have experimented with Bundled Payment Programs with limited success. After factoring in bonus payments to providers, the net savings to Medicare has been minimal, and on the positive side, there is no… Read More »
As we continue to focus on value-based payment models, there is a strong belief that moving away from fee-for-service payments towards a per-patient rate for primary care providers will decrease overall costs. The counter concern is that this may also lead to reduced care because of the financial incentive to avoid services. Primary care providers (PCPs) have the… Read More »
Healthcare is an industry where innovation and technology continue to progress and create an opportunity to improve lives. However, the cost of such products continues to rise and thus impacts the overall cost of care. But, suppose one surmises the purpose is to enhance care in a manner that delivers value, i.e., where the expense plays a significant… Read More »