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Currently practicing in a FFS model (like most) RVU-based, so once base RVU achieved then bonus kicks in $x/RVU over base RVU requirement.
Our medical director keeps talking about how this model is going to change and having large patient practices to keep the RVU-wheel turning will go by the wayside. Most of my colleagues, mostly elder of me, state this conversation (or threat depending on your perspective) has been going on for awhile. Even our CEO of the hospital talks about 80/20, 50/50 and then 20/80 (RVU/Value reimbursement).
I'm wondering, how will reimbursement for value-based care look? I understand looking at populations the local providers care for and getting a total allotment of money for certain diagnoses, which transitions risk more to the hospital/providers. Keep the patients out of the hospital, use lower costing medications, perform only necessary procedures (TKR in 80yo and multiple back surgeries for non-debilitating/limiting pain come to mind) to keep all costs down. Home visits will be in vogue now.
In the FFS model, seeing more patients generates more RVUs, which puts you over your RVU base and generates a higher bonus/return - easy to comprehend. An est. pt for routine f/up is probably a level 3 (0.97 RVU) or level 4 (1.5 RVU). I have seen contracts with 5K RVU base requirement and as high as > 10K (larger practices, certainly larger base salary). However, how is the actual payment model going to be for value-based care? I guess I just can't really wrap my head around how the reimbursement from day to day will be - and it seems the more people you see the more you generate (or are allotted given seeing more diagnoses) similar to FFS/RVU.
Appreciate any thoughts or experiences directly with value-based reimbursement
Our medical director keeps talking about how this model is going to change and having large patient practices to keep the RVU-wheel turning will go by the wayside. Most of my colleagues, mostly elder of me, state this conversation (or threat depending on your perspective) has been going on for awhile. Even our CEO of the hospital talks about 80/20, 50/50 and then 20/80 (RVU/Value reimbursement).
I'm wondering, how will reimbursement for value-based care look? I understand looking at populations the local providers care for and getting a total allotment of money for certain diagnoses, which transitions risk more to the hospital/providers. Keep the patients out of the hospital, use lower costing medications, perform only necessary procedures (TKR in 80yo and multiple back surgeries for non-debilitating/limiting pain come to mind) to keep all costs down. Home visits will be in vogue now.
In the FFS model, seeing more patients generates more RVUs, which puts you over your RVU base and generates a higher bonus/return - easy to comprehend. An est. pt for routine f/up is probably a level 3 (0.97 RVU) or level 4 (1.5 RVU). I have seen contracts with 5K RVU base requirement and as high as > 10K (larger practices, certainly larger base salary). However, how is the actual payment model going to be for value-based care? I guess I just can't really wrap my head around how the reimbursement from day to day will be - and it seems the more people you see the more you generate (or are allotted given seeing more diagnoses) similar to FFS/RVU.
Appreciate any thoughts or experiences directly with value-based reimbursement
