Medicare Value-Based Payments (also Called Alternative Payment Models) to Hospitals Fall Into 3 Main Categories:
1 - Pay for Performance (P4P): There are 3 Sub-Types of Pay-for-Performance
--Value-Based Purchasing: Fee-for-Service with $1.5B at Stake in Quality Bonuses to be Paid-out by Penalizing those Hospitals with Poor Quality. Budget Neutral for Medicare.
--Readmission Reduction: Fee-for-Service with 3% Penalty for Readmissions for 6 Conditions, Only Downside for Hospitals, No Upside. Medicare Saves.
--Hospital-Acquired Conditions (e.g. Catheter-Associated Urinary Tract Infection): Fee-for-Service with 1% Penalty, Only Downside for Hospitals, No Upside. Medicare Saves.
2 - Bundled Payments: Fixed Payment for 32 Different Episodes of Care, Voluntary Program
--Fixed $ Amount for Hospital + Doctor + Post-Acute Care
--Program is Shrinking: Participating Hospitals from 830 to 715
3 - Shared Savings: Accountable Care Organizations (ACO) - Fixed Payment for a Population of Patients for a Certain Period of Time (aka 'Capitation'), Voluntary
--517 ACOs Currently Care for 11.2 Million Medicare Beneficiaries - 28% of Total Traditional Medicare Population, BUT 56% of Hospitals Plan on Ending Their ACO
Sources:
Advisory Board Company Slide Presentations Previously Shared Publicly on the Internet.
AHealthcareZ is 200+ Healthcare Finance Educational Videos.
💥 BOOK: Check out Dr. Bricker’s Book 16 Lessons in the Business of Healing here: [ Ссылка ]
AHealthcareZ Viewers Include: Employee Benefits Professionals, HR, CFOs, Insurance Brokers, Benefits Consultants, Doctors and Nurses in Leadership Roles, Hospital and Health System Administrators, Health Insurance Carrier and PBM Professionals, Pharma and Med Device Professionals, Academic Professors and Students in Healthcare Administration and Public Health.
90,000+ Views Per Month Across All Platforms.
Visit AHealthcareZ.com to Subscribe to the Healthcare Finance Video Newsletter.
#HealthcareCosts #HealthcareIndustry #MedicareAlternativePaymentModels
