Payment Models

ANSWERS

Health care is currently transitioning from a payment system based on the volume of services provided (fee-for-service) to a payment system based on the value of those services (value-based care and alternative payment models).

The Centers for Medicare & Medicaid Services has set a goal of increasing the value of Medicare payments. For example, CMS estimated that nearly a third of Medicare payments were attributed to alternative payment models as of January 1, 2016. As a result, hospitals and health systems must exist in both the fee-for-service and value-based worlds for the time being. They must, in particular, continue to serve and operate within traditional, siloed payment systems like Medicare’s inpatient and outpatient prospective payment systems.

They must, however, start thinking about how they will take financial responsibility for the quality and costs of an entire episode of care or attributed population, such as under the Comprehensive Care for Joint Replacement bundled payment or Accountable Care Organization programs.

QUESTION

Payment Models

Visit the AHA homepage. https://www.aha.org/advocacy/current-and-emerging-payment-models

Choose two of the 17 payment models that are closest to your area of practice (long-term care facility). Summarize the payment model and the implications of this information on future practice and patient care delivery.

APA 7 format and 300-500 words