Value-Based Reimbursement Models

There’s a reason the healthcare industry is shifting toward value-based reimbursement models and away from volume-based care. Value-based care reimburses healthcare providers based on the quality of care they provide, rather than providing payment for each test or procedure. Value-based care incentivizes the quality of patient care over quantity; outcome-based reimbursement is the goal, benefiting both the patient and the provider.

The traditional model of volume-based reimbursement, otherwise known as fee-for-service care, is based on the number of services performed by a healthcare provider. Providers are paid based on the number of patients they have and the number of tests and procedures they order. The more tests ordered, the higher the payment.

Value-based care emphasizes high-quality, lower cost, and preventive patient care. Rather than be reimbursed for each test ordered, providers have incentives to collaborate and reduce redundant care.