5 Conceptual Templates For Value-Based Reimbursement

1. PAY-FOR-COORDINATION: pays primary care physicians a monthly fee to lead and to coordinate a partnership of health care between providers, care managers, specialists, Medicare patients & families.
2. PAY-FOR-PERFORMANCE (P4P): offers a direct and simple approach to reimbursement, linking payments to quality and value.
3. BUNDLED PAYMENT OR EPISODE-OF-CARE PAYMENT: healthcare providers receive a fixed reimbursement for multiple services provided to beneficiaries during a specific episode of care or defined time period
4. SHARED SAVINGS PROGRAM (UPSIDE AND DOWNSIDE RISK): physicians form entity groups and provide population health management through a coordinated, team approach to care.
5. CAPITATION: assigns patients a per member, per month or annual payment, that providers receive to deliver a set of services, or all services, for a defined time.

Source: The Latest Insight blog/TXCIN, May 2, 2018
Source URL: http://www.insight-txcin.org/post/the-five-conceptual-templa...

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