Listen to Irving Stackpole at the discuss how to survive & thrive in a value-based payment environment, courtesy of our friends at Pharmacy Podcast Network.

There is an inarguable shift occurring within healthcare from “volume” based reimbursement (fee-for-service) to “value” based payment. This shift is seen in various models for payment including, Accountable Care Organizations (ACOs) and Bundled Payment for Care Initiatives (BPCI).

By the end of 2018, 50% of Medicare payments will be based on value, rather than fee for service (the dominant current model for payment). This change is intended to both slow the increase in healthcare spending in the US and to improve the value of services provided.

The transition from “volume” based payments (fee-for-service) to “value” based payments is momentous. For decades, more services provided to patients or “consumers”, translated to higher provider payments. But now – what do we do?

Insurance companies and other intermediaries are in the habit of dictating levels of payment, utilization & length of stay, and in the current environment, providers’ experience is no different. Will provider managers be simply told what to do, or can we develop a pro-active model?