Our Care Model
CHI Health is moving to a value-based care model, and away from the current fee-for-service model.
In a fee-for-service model of reimbursing providers for health care, providers and health care organizations are reimbursed based on the volume of services provided instead of the outcome. Essentially, they are incentivized to "do" more. Ordering more tests, seeing more patients, and performing more procedures - regardless of medical necessity - results in higher costs. This model, while guaranteeing payment for all services delivered, is not always informed or driven by evidence of better health outcomes.
A value-based payment (reimbursement) system is structured around achieving certain care quality goals for a given population of patients at a pre-determined cost. Value-based care focuses on providing the right care, at the right time, in the right place to achieve the best outcomes for patients at the most affordable cost.
In a value-based care model physicians and hospitals are measured - and paid - for providing better quality care with better patient outcomes. It places more focus on preventive care, to keep people healthy and prevent expensive ER visits and hospitalizations.
Learn More About Value-based Care:
- UnitedHealth's $43 Billion Exit From Fee-For-Service Medicine -Forbes
- Value-Based Care models are occurring around the country
- Midwestern providers, payer blaze trail toward value-based care - Healthcare Finance News
- Patient Engagement Tips from Catholic Health Initiatives - HealthLeaders Media
- Anthem, HealthCare Partners Save $4.7 Million by Coordinating Care - LATimes.com
- Aetna Marches on with ACOs - Healthcare Payer News
- Principles for Consumer-friendly Value-based Insurance Design - FamiliesUSA
- What Is Value-Based Health Care? - International Foundation of Employee Benefit Plans
- The Strategy That Will Fix Health Care - Harvard Business Review
- Video: A Population Health Management Dilemma