Value-Based Reimbursements

Even though fee-for-service models are still around, the shift to value-based care and value-based reimbursements is here. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is a volume to value transformation where traditional fee for service payments are being replaced with a financial incentive framework that rewards for improved quality, outcomes and costs. While the law directly impacts mostly Medicare payments today, the groundwork is laid and strong incentives are provided for other payers to move in the same direction, thus potentially disrupting the healthcare system at all levels.

Today, value-based reimbursements are a double-digit multi-billion dollar market. However, health systems are struggling to see this revenue grow into their organizations. Why? Because successful implementation of a value-based reimbursement program requires a groundbreaking combination of strategic planning, financial planning, care model transformation, physician engagement and alignment, organization transformation and technology and analytics. Significant revenue and risk are at stake.

While 4D Healthware is designed for the value based world that is here and growing, it also ties into the volume-based, fee-for-service system that is here today. 4D Healthware guarantees that use of their software and clinical engagement team will lead to successful capturing of both, the fee-for-service and the new value-based revenue opportunities. In addition, we offer consulting services that aid a practice in the organization transformation efforts required to support patients and manage practice operations in this new model of care. Healthcare organizations who survive and thrive during this shift to the new value-based payment models will be the ones that strategically embrace change and customize the broad array of value focused shared saving, shared risk and bundled payment models that will work for their individual organizations and patient populations.

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