Fee-for-service (FFS) is health care’s most traditional payment model, but how does it compare to value based care? We give you the answers.

1. THE FEE
FOR
SERVICE
DILEMMA
BY TXCIN

2. Fee-for-service (FFS) is health care’s
most traditional payment model
where physicians and healthcare
providers are paid by government
agencies and insurance companies
(third-party payers), or individuals,
based on the number of services
provided, or the number of
procedures ordered.

3. THE
DILEMMA
In 2010, the Affordable Care
Act (ACA) set in motion a new
vision for healthcare delivery
and reimbursement—value-
based care—aimed at
replacing the “broken”
traditional fee-for-service
model, which continues to
bear the blame for out-of-
control healthcare spending
that accounts for 18% of the
United States’ 2017 Gross
Domestic Product (GDP).

4. THE
DILEMMA
The concept of value-based
care relies on the
implementation of alternative
payment models, e.g.,
Accountable Care
Organizations (ACOs) and
Patient-Centered Medical
Homes (PCMHs), that
reimburse health care
providers based on cost-
efficiency, coordination, value,
and quality, rather than simply
the number of services
provided.

5. The current design of the American
health care system—how it’s
structured and financed—dates
back more than 100 years (Pearl),
and there have been unsuccessful
attempts to “overhaul” it in the
past.

6. TODAY'S
HEALTHCARE
SYSTEM
Today, America’s healthcare system is
experiencing another attempted overhaul. At
a recent March 2018 Federation of American
Hospital’s policy conference, Health and
Human Services Secretary Alex Azar stated
that “there is no turning back to an
unsustainable system that pays for
procedures rather than value.

7. TODAY'S
HEALTHCARE
SYSTEM (CONT.)
The U.S. government, specifically the Centers
for Medicare and Medicaid Services (CMS),
has a determined focus to “repair” the
current healthcare payment system, with
plans to transition the healthcare industry to
a more value-based reimbursement
environment.

8. Want
More?
http://www.insight-
txcin.org/post/what-is-fee-
for-service

9. ABOUT
TXCIN
North Texas Clinically
Integrated Network, Inc. (dba
TXCIN) is a non-profit ACO
that began in late 2014. A
small group of independent
physicians aligned to initiate
clinical integration and value-
based contracting. Partnering
with RevelationMD and its
state-of-the art information
platform, TXCIN has become
the largest independent
network of physicians in North
Texas.