As the U.S. healthcare system continues on its march from volume to value-based payment, providers are experimenting with myriad new programs designed to share financial risk, assume capitation contracts, generate reimbursement for outcomes and avoid costly penalties. The basic idea: In the not-so-distant future, hospitals will no longer be paid for what they do, but for what they don’t have to do.
“Value-based care flips the entire current American hospital model on its head,” said Robert Havasy, senior director of health information systems at HIMSS. “Everything that was a cost becomes potential revenue, and everything that was revenue becomes a cost to be controlled. … Expensive hospital utilization becomes a cost that you want to reduce.”