As value-based wave breaks, 4 options for practices still stuck in fee-for-service

Why This Topic Matters

The transition in reimbursement affects practice finances, contracting, infrastructure needs, and long-term viability. Readers can use the article to understand the general landscape and to compare high-level organizational responses without needing to navigate the broader value-based payment trend blind.

Article Sections

1. Pay for performance

   Introduces the broader shift away from fee-for-service and summarizes the reimbursement environment across Medicare, private payers, and practice surveys. It frames the growing role of alternative payment models and value-based contracting.

2. FFS days are numbered

   Discusses the pressures encouraging practices to move toward alternative payment structures and the general incentives influencing provider behavior. It focuses on the market context rather than specific coding or billing mechanics.

3. What to do?

   Outlines broad strategic options for practices that have delayed participation in value-based reimbursement. The section presents organizational and operational paths that different practices may consider based on their resources and goals.

4. Quit.

   Covers the option of remaining in fee-for-service for practices nearing retirement or otherwise planning to exit soon.

5. Go DPC.

   Describes direct primary care and other cash-based practice approaches as alternatives to third-party payer participation.

6. Join up.

   Explains the general idea of aligning with larger organizations or networks to support value-based participation and related infrastructure needs.

7. Experiment with low-impact programs.

   Reviews the concept of limited-risk or upside-only programs as entry points into value-based reimbursement and practice transformation.