Question

• What is driving the rapid move from volume to value in the U.S. healthcare payment system.

Answer 1

Quality and Cost of Healthcare Systems are most serious issues discussed now-a-days. The major cause for these problems are Volume Driven Care and Value Driven Care where this includes Physicians, Hospitals and Other Providers to gain increased revenues and profits by giving more services to more patients which may also improve the outcomes.
i) Volume-Based care is basically refered to the payment where a health care provider receives for services that a patient might need which means the Quality of service does not really make a difference. This is also called as fee-for-service-care.
ii) Value-Based care mostly focuses on getting value from quality services where here the payments are on basis of the specialized care and also includes cost reduction. Preferably known as Accountable Care.
In U.S. Healthcare Systems these payment methods were driving providers to feel guilt about the number of patients cared rather than value to be provided. Here those who measure success rate were primarily focused on profits when compared to the cost of each service, which rapidly caused some health care providers to speed through patients. These payment transitions are not much easier than to be done, and switching from Volume to Value is definitely a challenging move on healthcare systems. Value based care does not give importance on Health Care Providers to elaborately discuss on issues and judge completely on patients instead it is just an rectifying process on asking common complains and ensure the satisfcatory section alone. It is most important to note in these cisrcumstances to make a change on these methods where an Organization should be fulfilly prepared to make this particular change.
In concern of past 30 years financial status of United States shows the changes and in 1980s these Health Plans which is being led by the U.S. Federal Government through Centers for Medicare and Medicaid Services transitioned from Volume based care to Value Based Care. In 2012 Center for Medicare and Medicaid Services introduced the Value-Based Programme that uses Outcome-based quality, satisfaction and utilisation measures as the basis for earn back incentives or straight penalties. Value based care and Population Health creates thes conditions which is favourable for patients as well as providers. Henry Ford Health System (HFHS) introduced dozens of population Health management programmes to leverage people, processes in these new payment technologies and broad-success in value-based care requires a Holistic and Organisation-wide transformation.
  Culture and Leadership, Operations, technologies and Partnership, Physicians Strategy, and Risk-based contracting expertise are the essential aim for the rapid move from Volume to Value Healthcare Payment Systems. Since Accountable Care Organization (ACO) became a network of doctors and hospitals who shares responsibility for providing care for attributed patients, risk based arrangements share providers in savings or losses with the payer, based on the negotiated risk contract. Healthcare costs which describes member , month per (PMPM) with the pre-quality and service metrics are tracked against target performance representing the potential shared savings pool. Increasingly even non government payers and large employers are entering into contracts with these Healthcare Organizations using similar Value based parameters.