VBR vs FFS the New Future is Here
Written by Editor   
Wednesday, April 15, 2015 12:00 AM

A shift toward value-based reimbursement, which only a couple of years ago seemed very slow in the making, may unseat the entrenched fee-for-service (FFS) payment model in five years, according to experts.  Health care usually moves glacially, but that’s not what’s happening here.  A move away from FFS payment will mean that contracts with thousands of provider groups will have to be rewritten.

In its first scorecard on payment reform, released in March 2013, the Catalyst for Payment Reform (CPR), a not-for-profit organization that advises large employers and insurers about quality improvement, reported that just 11% of payment to providers is not under a FFS model.

Well, guess what? CPR’s second report card last year found that 40% of commercial health plan payments were made through payment methods designed to improve quality and reduce waste

That’s quite a jump—but not a complete surprise, considering the clues. Top executives at UnitedHealthcare, Anthem Blue Cross, and Aetna have all been quoted in recent months about the concerted value-based efforts their companies are making. CMS is throwing its weight behind the trend by mandating that 30% of Medicare outlays by 2016, and half by 2018, be routed through alternative payment models such as ACOs and bundled payments.

McKesson Health Solutions has no doubts about which way the wind is blowing. After surveying top-level managers at 114 payers and 350 hospitals, the consulting company said that “there can be no question as to health care’s embrace of value-based models” and reported that the payment landscape is changing so fast that value-based payment will overtake FFS by 2020. In fact, according to McKesson’s findings, the future has already arrived, with 90% of payers and 81% of providers using some mix value-based reimbursement and FFS.


Source:  http://www.managedcaremag.com/archives/2015/4/value-based-reimbursement-coming-strong-while-fall-ffs-medicine-accelerates