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Vital Directions from the National Academy of Medicine
October 25, 2016

More Value From Payment Reform in Health Care and Biomedical Innovation

Author Affiliations
  • 1Geisinger Health System, Danville, Pennsylvania
  • 2Duke University, Durham, North Carolina

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;316(16):1653-1654. doi:10.1001/jama.2016.14670

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.