Fee for Service Reimbursement

Consumer Advocacy Orgs Share How to Move Away From Fee-For-Service Payment

March 1, 2024 - As healthcare spending rises, shifting away from fee-for-service payment and delivery models that incentivize volume over value is imperative. Families USA and other consumer advocacy groups are urging policymakers to implement reforms that improve healthcare affordability and quality and support the transition to value-based care. Families USA,...


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Less than Half of Primary Care Physicians Participate in Value-Based Care

by Victoria Bailey

Value-based care participation is lacking among primary care physicians; most practices reported receiving fee-for-service payments in 2022, according to data from the Commonwealth Fund. Value-based...

MedPAC Recognizes Impact of Inflation on Docs, Suggests Higher Rates

by Jacqueline LaPointe

The Medicare Payment Advisory Committee (MedPAC) recommended increasing physician payment rates based on an inflation-based index for Medicare. The independent advisory group suggested in its March...

Value-Based Payment, Fee-for-Service Levels Hold Steady

by Jacqueline LaPointe

Value-based payment levels barely moved in 2021, with some movement in the downside financial risk category, according to the latest data from the Health Care Payment Learning and Action Network (HCP LAN). The majority of healthcare...

What Is Healthcare Revenue Cycle Management?

by Editorial Staff

While hospitals, small practices, and larger healthcare systems are known for saving lives and treating patients, every healthcare organization needs to develop successful processes and policies for staying financially healthy. That is...

Investor-Owned Health Systems Linked to Most Low-Value Care

by Sarai Rodriguez

Overuse of low-value services was most often seen in healthcare systems that had more beds, had fewer primary care physicians, had more physician practice groups, and were...

Study Finds Low-Value Services Increases Risk for Direct Harm

by Sarai Rodriguez

A study analyzing Choosing Wisely recommendations found that nearly 50 percent of identified low-value services may cause direct potential harm. Published in JAMA Network, researchers...

Risk-Based Revenue Stalls Despite Challenges with Fee-For-Service

by Jacqueline LaPointe

Most hospitals suffered heavy financial losses during the COVID-19 pandemic as a direct result of the fee-for-service payment system, yet progress toward a more stable, risk-based revenue structure...

HHS Paying Providers for Underinsured Vaccine Administration

by Jacqueline LaPointe

HHS has announced a new program designed to reimburse providers for administering COVID-19 vaccines to underinsured patients. The COVID-19 Coverage Assistance Fund (CAF), launched Monday through the...

Medicare FFS Claims Suggest Targeted Low-Value Care Interventions

by Hannah Nelson

Hospitals that are for-profit, non-teaching, and/or located in the South administer the highest rates of low-value care among traditional Medicare beneficiaries, according to a new study published in...

Financial Incentives Biggest Barrier to Social Determinants of Health

by Emily Sokol, MPH

The success of social determinants of health strategies is contingent on funding and supportive financial incentives, providers revealed in Insights by Xtelligent Healthcare Media’s latest...

Telehealth Reimbursement Just for Value-Based Providers Post-COVID?

by Jacqueline LaPointe

The Medicare Payment Advisory Commission (MedPAC) is the latest group to weigh telehealth reimbursement expansions after the COVID-19 pandemic. In a meeting held virtually last week, MedPAC analysts...

How COVID-19 Imperiled Physician Practices, And How to Save Them

by Jacqueline LaPointe

Some have heard the ringing of the death knell for physician practices for years now. Mergers and acquisitions, industry consolidation, value-based care, and the growing presence of private equity firms in healthcare have all threatened...

Healthcare Reimbursement Still Largely Fee-for-Service Driven

by Emily Sokol, MPH

Value-based reimbursement is frequently cited as healthcare’s silver bullet. Changing the way providers are incentivized to deliver care can alter care delivery, placing the focus on...

Third of Execs Don’t Think Value-Based Payment Will Usurp FFS

by Jacqueline LaPointe

Value-based payment adoption has steadily increased, but a third of healthcare executives in a new survey do not believe the alternative payment mechanism will usurp fee-for-service. Fee-for-service...

90% of Value-Based Payments in Commercial Sector Based on FFS

by Jacqueline LaPointe

The proportion of value-based payments from the commercial sector to physicians and hospitals increased from 10.9 percent in 2012 to 53.0 percent in 2017. However, an overwhelming majority of those...

AMA Bolsters Healthcare Economics Training for Future Physicians

by Samantha McGrail

The American Medical Association (AMA) adopted a new policy calling on all medical schools and residency programs to include healthcare economics training related to the structure and financing of the...

Medicare Fee-for-Service Improper Payments Drop By Over $7B

by Jacqueline LaPointe

CMS recently announced that the Medicare fee-for-service (FFS) improper rate declined further from fiscal years (FY) 2017 to 2019, reaching the lowest level since FY 2010. The FY 2019 Medicare FFS...

Trump Seeks to Tie Fee-for-Service to Medicare Advantage Rates

by Jacqueline LaPointe

An executive order signed by President Trump on Thursday directs HHS to explore tying Medicare fee-for-service rates to those negotiated for Medicare Advantage plans and other market-based pricing...