Key Points from the Article on Risk-Based Payment Models:
- Payers are increasingly favoring value-based care, which reimburses for outcomes rather than services, focusing on long-term health. This shift is driven by the need to reduce healthcare spending.
- To encourage physicians to adopt value-based contracts, payers offer risk-adjusted models where physicians assume some financial risk but also share in the savings. This model can increase revenue and profit if practices invest efficiently in preventive care and technology.
- Medical Economics spoke with Patrick Sulzburger, CPA, owner of Coding and Compliance Initiatives, about the advantages and challenges of risk-adjusted payment models and strategies for successful implementation.
- These models recognize patient complexity and aim to pay providers fairly based on patient care complexity. They are a step towards value-based healthcare, encouraging efficient, quality care delivery.