The transition from fee-for-service to value-based care requires thoughtful orchestration of the people, processes, and policies across disparate parts of the care continuum. The complexities and interdependencies of this evolution require a firm understanding of the drivers of quality, cost efficiency, and physician alignment.
About the Value Project
HFMA's Value Project helps healthcare organizations create value for the multiple purchasers of health care. The transformation toward a value-based healthcare system is reshaping the delivery of care, patient expectations, and payment structures.
In the resources HFMA has produced for the Value Project, healthcare finance leaders and clinical partners come together to:
- Define the practices of providers who are leading the way toward a value-based healthcare system
- Describe the primary capabilities that healthcare organizations will need to develop in the areas of people and culture, business intelligence, performance improvement, and contract and risk management to improve the value of care provided
- Provide specific strategies, tactics, and tools that healthcare organizations can use to build, enhance, and communicate their value capabilities
- Identify the trends today that are defining the future state of value in health care and describe new care delivery models that could help healthcare organizations create value
Value Project Resources
- PHASE 3
HFMA's Value Project looks at the new wave of acquisition and affiliation activity in health care, defining the drivers of this activity, options for value-focused affiliations, and key legal and regulatory issues.
- PHASE 2
What are healthcare purchasers expecting in terms of value, and how are provider organizations working to deliver value? How does the business model for value differ for different types of hospitals and health systems? See how leading provider organizations are answering these questions in resources from Value Project Phase 2.
- PHASE 1
What is the value equation from the purchaser's perspective, and what key capabilities should healthcare provider organizations develop to prepare for a value-driven future? Find the answers in HFMA's Value Project Phase 1 reports and web tool.
Value-Based Payment & Delivery Models
The cost of healthcare has led policy makers to rethink how care is delivered and providers are paid. Fee-for-service payments are likely to continue their decline as we transition towards a value driven healthcare system that rewards high quality and cost effective patient care. Established under authority of the Affordable Care Act (ACA), the Center for Medicare and Medicaid Innovation will play a central role in this transition by testing and implementing payment models that demonstrate quality improvements and cost savings.
The following resources provide information about some of these payment models that are focused on encouraging high value care delivery through greater integration, improved care coordination, and a focus on patient safety. These models are designed to foster a culture of accountability that rewards high quality and cost effective care.
Accountable Care Organizations are legal entities which are designed to allow integrated networks of providers that improve patient outcomes and lower costs to share in the savings that come from more coordinated care.
Provides information on Medicare's plans to confidentially and publicly report physicians' cost and quality of care and to implement a physician pay-for-performance program.
A pay-for-performance program that links a percentage of hospitals' Medicare payments to their performance or improvement on certain measures.
Reduces hospitals' payments based on their percentage of potentially preventable Medicare re-admissions for certain high volume and cost conditions for which their are risk-adjusted re-admission measures.
Describes Medicare's current Hospital-Acquired Conditions payment policy and plans to implement future payment adjustments for conditions acquired in the hospital and alternate setting.