When it comes to Health care providers, Service or Value? That is the question?
It’s called Obama Care. In quality we call it value based care.
Traditionally re-imbursement models have been defined by fee for service. Whether it is programs like Medicare and Medicaid like in the United States, private insurance or even self-pay. We even see this in socialized medicine. The fee is dependent on volume. Volume of patients. Volume of labs and radiology. In some places, physicians are even incentivized on these procedures.
The new transition if from volume to value-based care. A shift from a fee for service model to a system where providers are re-imbursed on quality, outcome and cost
So you might ask yourself what is value based care? Value, is better care at a lower cost. So how do we achieve this?
We introduce different programs to our hospitals that will help. Value based purchasing for hospitals. Physician quality reporting. We also introduce penalty in hospital acquired conditions, preventable readmissions and poor physician documentation.
Incentivization of physicians will depend on better patient experience, better staff experience, reduced cost and better healthcare outcomes instead of number of patients and/or labs requested.
This transition is moving medicine to better patient outcome. It might look like the fee will be lower but with better outcome, better trust and commitment practices will grow and fees will flourish.
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By Dr. Rola Ali-Hassan, CCFP
Consultant Family Medicine