Driven by skyrocketing costs, market forces are hastening the shift in the healthcare industry from volume based care (fee for service) to a value based reimbursement structure (fee for value). While the inertia of entrenched policies, regulations, organization structures, and systems have held back the tide, industry analysts agree that the tipping point is being reached.
The evolution towards this model is accelerating as patients, healthcare providers and payers realize its many benefits. The “value” in value-based healthcare is derived from measuring health performance metrics against the cost of delivering those metrics.These reimbursement models encourage healthcare providers to deliver the best care at the lowest cost. In turn, patients receive a higher quality of care at a better value.
Robert Blank is a managing consultant at EVERSANA, working extensively in revenue management software solutions for the pharmaceutical and medical device industries. His expertise includes Medicaid and Managed Care rebates, chargebacks, and membership management. He has developed custom client solutions around value based contracting, formulary validation, discount reallocation, and the 340B Drug Pricing Program. In […]