Understanding Value-Based Payment: A Primer for Family Physicians


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Supplement sponsor: American Academy of Family Physicians.

Fam Pract Manag. 2020 Jul-Aug;27(4):25-28.

The health care landscape evolves at a rapid pace. One trend among payers that impacts family physicians and other health care providers is value-based payment. Public and private payers are transitioning away from fee-for-service (FFS) and emphasizing value-based payment models.

Delivering High-quality, Value-based Care

This is a critical time in health care for family physicians to emphasize that primary care is value-based care through comprehensive, longitudinal, high-quality care that reduces cost and improves outcomes. For solo, independent physicians, changes in revenue from these new models will have a direct impact on your practice’s bottom line. For employed physicians, employers will begin to place a greater emphasis on performance on quality and utilization of care in determining compensation.

Value-based Payment Concepts

The overarching goals of transitioning from volume to value-based payment models are shared financial risk and holding physicians and other health care providers accountable for the quality and cost of health care. The key concepts of value-based payment (i.e., shared risk, population-based payments, bundled payments) align with providing value to patients through incentivizing outcomes. However, these payments alone are not sufficient to achieve a value-based care system.

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