5 Trends in Healthcare Reimbursement

Authored by: Abby Norman

The subject of physician compensation is a hot one as of late. With all the changes in the financial sector of healthcare, and the push to save money, there has likewise been a focus on how- and how much- physicians are being compensated.

ACOs | Healthcare Reimbursement

A major change that has already begun to take place in many healthcare systems nationwide is Accountable Care Organizations (ACOs). While it’s likely too soon to know if they will work long term, in theory they will reduce the tendency of ‘silos’ in healthcare and lead to better coordination of patient care. Ultimately, these changes will usher in more cost savings- healthier patients will stay out of the hospital. While it might seem counterintuitive – how will doctors make money if their patients are healthy? – the reality is, even though the US is spending around 17% of the GDP on healthcare, population health measures don’t support the theory that spending more money means healthier patients – in fact, compared to other developed nations, our patients aren’t very healthy at all.

No More Fee-For-Service | Healthcare Reimbursement

The traditional payment model is slowly but surely fading into the background of healthcare history and making way for new models – but slowly is the operative term here. A solid percentage of healthcare providers are still operating under the traditional model – where providers are paid for the tests or procedures ordered regardless of their pertinence to the patient – and therefore healthcare spending continues to spiral. Under this model, it isn’t profitable for physicians if their patients are healthy and stay out of the hospital. Because we’ve operated under this model for so long, this assumption remains and it has informed the overall structure of our care models for several decades. With more and more healthcare organizations moving away from this model, however, sooner or later we’re likely to see a shift not only in payment – but paradigm.



Josh Sandberg

Josh Sandberg is the President of Ortho Sales Partners and Partner for The De Angelis Group. He also serves as Co-Founder and Editor of OrthoSpineNews.

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