Value-Based Care: The Next Stage of Medical Finance

Abstract

The healthcare system in the USA has expanded the use of an alternative to its traditional fee-for-service programs. This paper is built on the need one Bayamon Medical Office has to develop a transition plan to change their fee-for-service model into a value-based care model. This plan focuses on the implementation of a capitation payment plan. Capitation offers opportunities to influence the future of healthcare by improving the management of resources. For this plan, the development of new measures was needed. The first tool is a performance metric based on survey and questionnaire data to determine how effective the plan has become. The second tool was a risk strategy to tackle the diverse needs of the patients the office is charged with. Lastly, the organization of a new team was developed to manage and monitor the plan. Findings indicate the model would show a 22% decrease in patient health costs and a 19%-28% improvement in care quality and patient satisfaction. Key Terms ⎯ bundle-payment, capitalization, fee-for-service, value-based care.