Watch this DHHS video on currently legislated healthcare payment reform.
The U.S. health industry is reinventing itself from its very core.
The affordability crises, unsustainability of costs and an aging population are primary drivers fueling the need to reform. Legislation including the Affordable Care Act (ACA) and the Medicare Access and CHIP Reauthorization Act (MACRA) are accelerating this ‘transformation’.
The goal for payment reform is to shift U.S. health care spending significantly towards value based payments.
Many innovation models/mechanisms are being explored and evaluated to determine effectiveness in accelerating transformation of our healthcare system:
Today, most healthcare providers are paid on a fee for service basis but the ground is quickly shifting. To prosper beyond fee for service payment methodologies, prepare by focusing on:
Negotiate existing fee for service agreements articulating your Value Proposition – effectively secure economic benefits from renegotiating existing arrangements.
Understand risks/rewards with various payment models – chart a course that works for your practice today while setting up to succeed in the future.
Evaluate MACRA preparedness – identify gaps and start working through your MACRA action plan today.
Determine what APMs may be up your alley – understand the models and economic potential.
Improve revenue cycle practices – pinpoint opportunities for enhancement and maximize the ‘collectable’ dollar.
Collect what should be yours in terms of ‘potential’ dollars – don’t let your hard work yield less than what’s rightfully due.