Alternatives to fee-for-service (FFS) payment are becoming more widespread. The idea is to provide aligned financial support for reforms in health care that improve quality and efficiency. For example, many health care organizations have found that analyzing current treatment patterns and redesigning care pathways can enable more patients to be more engaged in their care and more effectively treated in outpatient settings or in their home. The new care models often use care teams, digital health tools that enable better monitoring and intervention, and considerable investments in analytics and support systems—all of which are generally not well supported under FFS. The models can potentially help ensure the appropriate use of costly technologies that are usually covered under FFS, such as breakthrough drugs and devices, which are under increasing pressure to demonstrate value in practice or face restrictions on access.
Feinberg DT, McClellan MB. More Value From Payment Reform in Health Care and Biomedical Innovation. JAMA. 2016;316(16):1653-1654. doi:10.1001/jama.2016.14670