The Rate Squeeze—How ‘Should’ Rates Be Set?

The squeeze on rising health and human service costs continues to cause conflict over reimbursement rates. What constitutes an adequate rate, and what managers of provider organizations should do when those rates are cut, was the subject of my briefing from a few weeks ago, Welcome To The Rate Wars. For the long term, I believe most provider organizations need a strategy for straddling the current (low) fee-for-service (FSS) rates while navigating the transition to value-based reimbursement. But that still doesn't resolve the questions about rates—because even payment based on "value" is still based on . . .