Review chapters Chapter 12 Coordinated Care Delivery Models Chapter 13 Policy and Advocacy Chapter 14 Building Cultures of Health and Wellness Within Organizations This week discussion topic: Give examples of types of care delivery services incentivized by volume based, fee-for-service payment models, as opposed to value based, alternative payment models.  Select one and explain, ‘ Purchase the answer to view it

There are various types of care delivery services that are incentivized by volume-based, fee-for-service payment models. These models prioritize the quantity of services provided over the value or outcomes of the care. In contrast, value-based, alternative payment models aim to prioritize the quality and value of care delivered. In this discussion, we will explore the examples of care delivery services incentivized by volume-based, fee-for-service payment models.

One example of a care delivery service incentivized by a volume-based, fee-for-service payment model is the provision of diagnostic tests or imaging services. In this model, healthcare providers are reimbursed based on the number of tests or imaging procedures performed. The more tests or procedures conducted, the higher the reimbursement. This payment model can incentivize healthcare providers to rely heavily on diagnostic tests, even if they may not be necessary or may not contribute significantly to patient outcomes. This can lead to overutilization of these services, which may drive up healthcare costs without necessarily improving patient outcomes.

Another example is the surgical procedures performed under a volume-based, fee-for-service payment model. Surgeons are typically reimbursed based on the number of surgeries they perform. This payment model can incentivize surgeons to perform more surgeries, regardless of the necessity or appropriateness of the procedure. This creates a potential conflict of interest, as surgeons may be motivated to prioritize the quantity of surgeries over the quality of care and patient outcomes. Additionally, this payment model may encourage healthcare providers to select patients who are more likely to require surgical interventions, which may further contribute to healthcare disparities.

Pharmaceutical prescribing is another area where volume-based, fee-for-service payment models can influence care delivery services. Healthcare providers may be incentivized to prescribe more medications, as they can receive reimbursement for each prescription written. This payment model can create a potential conflict of interest, as healthcare providers may be motivated to prescribe medications that may not be necessary or may not have the best efficacy or safety profile for the patient. Overprescribing of medications can contribute to healthcare costs and potentially expose patients to unnecessary risks.

Overall, these examples illustrate how volume-based, fee-for-service payment models incentivize the quantity of care delivered rather than the quality or value of the care. These payment models can create potential conflicts of interest and may contribute to overutilization of certain services, potentially driving up healthcare costs without necessarily improving patient outcomes.

In contrast to volume-based, fee-for-service payment models, value-based, alternative payment models aim to incentivize healthcare providers to deliver high-quality, cost-effective care. These models focus on rewarding healthcare providers based on the value and outcomes of care rather than the quantity of services provided. Value-based, alternative payment models often involve payment arrangements such as bundled payments or accountable care organizations, where healthcare providers are accountable for the overall cost and quality of care provided to a specific population of patients. These models encourage coordination of care, prevention of unnecessary services or procedures, and emphasize patient-centered care.

In conclusion, the examples provided demonstrate the care delivery services that are incentivized by volume-based, fee-for-service payment models and the potential implications of these models on patient care and healthcare costs. It is important to recognize the limitations of volume-based, fee-for-service payment models and the need for the transition to value-based, alternative payment models to promote high-quality, cost-effective care. Healthcare policy and advocacy efforts can play a crucial role in driving this transition and creating a healthcare system that fosters value-based care delivery.