Executive Briefings | May 2, 2015
The Payer/Provider Mismatch In Value-Based Contracting
Paying fee-for-service (FFS) is easy for both parties – for executive teams of payers and for provider organizations. One service = one rate.
Move to the range of options other than FFS – case rates, bundled rates, capitation rates, global budgets with elements of pay-for-performance – and the parameters are not always so clear. As my colleague, Monica E. Oss, CEO of OPEN MINDS, said at a recent meeting, "When you've seen one case rate, you've seen one case rate." And there are problems on both sides of the equation – how managers of payers develop contracts . . .