Providers are moving away from fee-for-service reimbursement toward value-based payments.
8/4/2020 9:00
By Michael Lamm
Corporate Advisory Solutions
ACA International member company Corporate Advisory Solutions (CAS) reports health care industry leaders are seeking a wider transformation in payment structures as the COVID-19 pandemic disrupts virtually all aspects of our national life, according to its Q2 2020 Tech-Enabled OBS M&A Market Report.
As many medical practices face the challenge of provider compensation under the fee-for-service model, providers are moving away from fee-for-service reimbursement toward value-based payments.
For example, fee-for-service does not offer equal pay for virtual and in-person care outside of the pandemic. Whether payers decide to make payment parity permanent or not, value-based payments can help fund telehealth and other value-added capabilities developed during the pandemic (such as triage call centers, remote patient monitoring and population health data) while ensuring a more predictable source of income for practices moving forward.
As the country takes steps to reopen, the health care revenue cycle will adjust to a new normal. In response to high unemployment and economic uncertainty, health care systems are implementing short-term strategies for patient collections. These strategies include:
- Short-term payment plans
- Suspended billing for 30 to 60 days
- Forgiven monthly payments
- Paused surprise billing
- Holds on placing accounts with debt collection agencies
- Suspension of any legal action normally taken against those with delinquent accounts
In this era of high-deductible health plans and cost-sharing arrangements, medical providers are developing collection strategies that include waiving patient cost-sharing; easing network, referral and prior authorization requirements; and covering diagnostic testing for physician-ordered COVID-19 testing.
As a result, health care organizations are increasingly motivated to select patient financing partners providing these capabilities:
- Front-end engagement with patients
- Pre-bad-debt programs
- Aged accounts receivables conversions
- Interest-free programs
- Dedicated medical call centers
- Upfront price transparency
- Contractual guarantees
- Convenient remote payments options online, by phone or by mail
- Automated data analytics to improve patient billing and increase enrollments, patient collections, and program satisfaction
Read more in the report here.
Michael Lamm, managing partner of CAS, hosts the ACA Cast podcast series Leadership Fuel With Michael Lamm. He is also a frequent contributor to ACA International's award-winning Collector magazine.