How Would Value-Based Reimbursements Affect Medical RCM?
It is no secret that healthcare in the United States is the most expensive in the world. Spending on medical services topped $4 trillion, more than the economies of all but a handful of countries. One of the main factors seen as being responsible for this is the existing fee-for-service model of reimbursements. Under the fee-for-service model, providers are paid for every service they offer. Needless to point out, this incentivizes many of them to provide too many services like tests, scans, etc. Amid the growing costs, the people and policymakers have been pushing for a change to a value-based model of reimbursements. Under the value-based model, providers will be reimbursed based on the clinical outcomes they achieve for their patients. However, this will require changes to existing healthcare RCM practices. The existing workflows require verifying health plans, coding clinical encounters, preparing claims, and processing payments. But this process would have ...