The last few years have seen many people call for a better system of payments in healthcare. The complexity and lack of transparency have only led to increasing costs, which ultimately hit the people on the lower rungs of the economic ladder. The existing system encouraged quantity over quality, which invariably led to all the problems that plague healthcare.

The value based payment is model has rendered the system highly fragmented and pushed greater spending by its very structure. It charges for every clinical visit, scan, test, and course of medication prescribed, and each of these is charged separately. Unsurprisingly, many patients wonder if they needed some of the tests or examinations administered.

Since it emphasizes quantity, disconnecting that factor from reimbursements is widely believed to help bring down the cost of healthcare. But it was easier said than done. Part of the costs was sucked up by the administrative aspects of running a healthcare organization. After every treatment or procedure, the non-medical staff at hospitals would have to fill out the claims for every procedure and submit them to the payers. Before that, they would have to verify if a patient’s health plan covers the treatments. Mistakes in the claims submissions (which aren’t uncommon) result in delays and rework for the staff, ultimately delaying payments to providers. Moreover, it doesn’t’ reward efficiency, quality of coordination amongst multiple providers. A disjointed web of payers and providers makes the workflows slower and more inefficient.

We hold restaurants, electronics manufacturers, car makers, and every company producing consumer goods accountable for quality. Then why spare the same for the healthcare industry? The goal of replacing the fee-for-service model is simple enough to hold healthcare organizations accountable for higher costs and quality. This sentiment among various stakeholders led to the inception of a value-based Reimbursement in healthcare.

As the model’s name indicates, there’s a greater emphasis on the value derived from the care received. This model of reimbursement rewards providers based on patient outcomes, pricing, access to care, and overall efficiency. Many experts agree that adopting such a method is the best solution to refine healthcare in the United States.