As mentioned in a previous blog, American healthcare has been steadily transitioning from the outdated fee-for-service payment method to the new value-based reimbursement model. Though this change promises better care for patients of all levels, it is still a relatively new system, meaning that there are a number of wrinkles to iron out first. These challenges come in a variety of shapes and sizes, but there are three major ones that overshadow the rest.
The biggest and most obvious challenge to overcome is the fact that the value-based reimbursement system is a change in general. While it has numerous benefits compared to the older system, the medical industry has spent decades using the fee-for-service system. Medicare still offers reimbursement according to this formula, forcing facilities and practices to handle reimbursement issues in multiple ways. This problem will shrink more and more as the value-based models become widely used, but until then, the challenge remains.
The next significant issue–which goes hand in hand with the first–is that the reimbursement switch requires providers to keep track of an enormous amount of data. Value-based policies already required facilities to monitor the number of cases of myocardial infarction, heart failure, and pneumonia, but that was only the beginning. Medicare is continuously adding new statistics that must be monitored, including 30-day and 90-day readmission rates. The more types of data there are to track, the harder it will be for healthcare professionals to make the switch.
The final issue is perhaps the hardest to accept: according to projections, value-based reimbursement will likely cause a significant short-term drop in revenue. Though it is hard to estimate exactly how much profits will drop of how long this decline will last, facilities are guaranteed to see a dent for at least a little while. This dip, however, is a necessary evil to implement the value-based process and fix any initial minor problems. Once the policies have had time to settle in, patient care will experience great improvement in the long run.