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. 2024 Dec;56(1):2382948.
doi: 10.1080/07853890.2024.2382948. Epub 2024 Jul 24.

Value-based healthcare payment models: a wolf in sheep's clothing for patients and clinicians

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Value-based healthcare payment models: a wolf in sheep's clothing for patients and clinicians

Forrest Bohler et al. Ann Med. 2024 Dec.

Abstract

Value-based healthcare payment models are an alternative insurance payment system that compensates healthcare providers based on their patients' outcomes rather than the individual services healthcare workers provide. This shift from the current fee-for-service model that predominates our medical system has received renewed popularity and attention within organized medicine such as the American Medical Association. Advocates believe that this new payment model will address many of the unsolved issues in healthcare such as medical waste and unsustainable healthcare costs. In practice, however, this model is plagued with a myriad of unresolved issues of its own. In this commentary, we outline these issues and suggest that the intentions of those advocating for value-based payment models are either misguided or disingenuous. We then offer solutions that preserve our current fee-for-service model while making necessary changes that will benefit both physicians and patients nationwide.

Keywords: Value-based healthcare; fee-for-service; health insurance; healthcare efficiency; insurance reform; patient outcome; physician reimbursement; population health; preventative medicine.

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Conflict of interest statement

The authors declare that they have no conflicts of interest with respect to the research, authorship, and/or publication of this manuscript. No financial or personal relationships with individuals or organizations have influenced or could be perceived to have influenced the work presented in this paper.

References

    1. Catalyst NEJM. What is value-based healthcare? Catal Carryover. 2017;3(1). doi: 10.1056/CAT.17.0558. - DOI
    1. RevCycleIntelligence . NAACOS, AMA push for long-term value-based care efforts. RevCycleIntelligence. 2023 Feb 24 [cited 2024 Feb 18]. Available from: https://revcycleintelligence.com/news/naacos-ama-push-for-long-term-valu....
    1. Magnan S, HealthPartners Institute . Social determinants of health 101 for health care: five plus five. NAM Perspect. 2017;7(10). doi: 10.31478/201710c. - DOI
    1. Kahn JG, Sullivan KR.. Promise vs. practice: the actual financial performance of accountable care organizations. J Gen Intern Med. 2022;37(3):680–681. doi: 10.1007/s11606-021-07089-6. - DOI - PMC - PubMed
    1. Heuer AJ. More evidence that the healthcare administrative burden is real, widespread and has serious consequences comment on “Perceived burden due to registrations for quality monitoring and improvement in hospitals: a mixed methods study”. Int J Health Policy Manag. 2021;11(4):536–538. doi: 10.34172/ijhpm.2021.129. - DOI - PMC - PubMed

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