As the notion of value-based payment has taken hold in the health care market – the concept that health care providers should be paid according to the quality of care they offer, as opposed to today's "fee-for-service" payment method – insurers, from the Centers for Medicare & Medicaid Services to commercial payers, have had to define and measure quality and value in health care.
And how those quality metrics are defined and collected, and how the payment measures are structured, vary from payer to payer – and even within different insurance organizations – as they experiment with various models to test what's most effective.
"Every payer has different metrics and different methods of payment," says Dr. David Nace, vice president of clinical development and medical director at McKesson. "That's the wild cowboy market economy we're in, and we need to move toward alignment."
Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.
Your access to unlimited BenefitsPRO content isn’t changing.
Once you are an ALM digital member, you’ll receive:
- Breaking benefits news and analysis, on-site and via our newsletters and custom alerts
- Educational webcasts, white papers, and ebooks from industry thought leaders
- Critical converage of the property casualty insurance and financial advisory markets on our other ALM sites, PropertyCasualty360 and ThinkAdvisor
Already have an account? Sign In Now
© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
