A new study appearing in American Journal of Managed Care examines how alternative payment models can be applied to emergency care, an area for which it can be difficult to obtain a clear picture of care costs.
The study authors suggest three methods in moving from traditional fee-for-service (FFS) payment models:
- Connect an existing FFS model to quality benchmarks and offer payment incentives to providers that meet certain criteria.
- Build a new payment model based on FFS, such as frequent-use programs for patients with complex medical, psychological, and social needs or bundled payments for certain episodic conditions.
- Move to a population-based, or capitated, system to give provider incentives to address care inefficiencies and prevent unnecessary trips to the ER.
Physicians have a key role in shaping FFS alternatives, and the Centers for Medicare & Medicaid Services should leverage doctors’ insights to determine how best to proceed, the study adds.