Commercial Payers and Value-Based Reimbursement

Let’s take a look at some examples of how commercial payers have embraced fee-for-value over the past few years.

More and more, private payers are either copying the Medicare models for value-based reimbursement or developing their own systems. What they all have in common is that they tie provider’s performance on measures of quality and efficiency to payment increases or other incentives, often incorporating a physician report card to compare the provider’s or the practice’s performance.
Whether your practice contracts with Medicare and Medicaid, private payers, or a combination you need to be ready for the shift to a system that pays for value rather than for volume. Over the next few years, your compensation will increasingly be linked to quality of care, patient satisfaction, outcomes, efficiency, and costs, whether you are billing government or private payers. Value-based reimbursement is here and it is time for all of us to prepare our practices to survive and thrive under the new system.