Traditional Fee-for-Service Payment Models Most Prevalent Among Physicians
Despite recent efforts to shift to alternative payment models, traditional fee-for-service payment remains the most prevalent method for physician visits, according to a recent report by the Agency for Healthcare Research and Quality (AHRQ).
The report, which summarized data from 1996 to 2013 taken from the annual Medical Expenditure Panel Survey (MEPS), focused only on physician outpatient visits. Visits were determined to be reimbursed either through fee-for-service or capitation, a payment model where a set amount is paid for each enrolled patient regardless of what care is rendered.
The researchers found that capitation use decreased from 6.6% in 2007 to 5.3% in 2013. Thus, as of 2013, as many as 94.7% of outpatient doctor visits were paid through the traditional fee-for-service framework.
According to the data, geographic location was found to have an impact on the payment model used. Capitation rates were higher in Western states (14.5%) than in states east of Colorado (3.2%). Researchers theorized this was due to the prevalence of HMOs in the Western part of the country.
Earlier this week, CMS announced the launch of a new multi-payer initiative to support primary care practices in providing high-quality care and transitioning away from the traditional fee-for-service method to value-based payment models.
Reference
