More than a decade after the passage of the Affordable Care Act, value-based care (VBC) is gaining momentum as providers and payers seek to improve patient outcomes while gaining control of runaway healthcare spending in the U.S. According to the latest Alternate Payment Model (APM) Measurement Report by the Health Care Payment Learning and Action Network (HCPLAN), 40.9% of U.S. healthcare payments flowed through two-sided risk payment models in 2020. Furthermore, an overwhelming 87% of health plans surveyed believe APM activity, including value-based contracts, will grow in the coming years.
The long-term success of healthcare providers and payers hinges on making a successful transition from traditional fee-for-service (FFS) payment models to VBC. Making VBC work, however, requires the ability to reimburse all participants in a VBC network for their services. And therein lies the challenge.
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