Perspectives
Moving Away from Fee-for-Service: Implications for Medication Adherence
Abstract
As part of the Patient Protection and Affordable Care Act (PL 111–148), the US Congress has required that the Centers for Medicare & Medicaid Services implement pay-for- performance programs in which reimbursement will be tied to patients’ treatment outcomes. Pay-for-performance models are an attempt at controlling healthcare costs while concurrently trying to improve the quality of the care that is delivered. This is a departure from the current system of fee-for-service, in which payment is based on the amount and type of care provided, and from capitated systems, in which payment is based on the number of covered lives; in each of these systems, payment may be independent of outcomes. Paying for results would change the financial incentives for healthcare providers; rather than putting the financial incentive on providing more care in fee-for-service or less care in a capitated model, paying for results aligns financial incentives to providing “better” care, at least in an ideal world.This content is limited to qualifying members.
Existing members, please login first
If you have an existing account please login now to access this article or view purchase options.
Purchase only this article ($25)
Create a free account, then purchase this article to download or access it online for 24 hours.
Purchase an SMJ online subscription ($75)
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
Purchase a membership plan (fees vary)
Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.