Provider Payment Reform & Value Based Payment Guide
Provider payment reform is a transition from traditional fee-for-service payment models to VBP models. Reform is occurring because of a widespread believe that increasing costs under fee-for-service models are not sustainable. VBP models feature payment structures linked to quality and outcomes, which reward both efficiency and effectiveness. The overall goals of VBP programs are to (1) provide better care to individuals, (2) improve the overall health of a population, and (3) reduce healthcare costs. Examples include pay-for-performance programs that reward improvements in quality metrics and bundled payment methods, which pay providers based on an episode of care rather than for individual services provided.