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Pay for Performance and Value-Based Care

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Abstract

In the past century, the face of medical compensation has changed on multiple occasions. The care delivery model (aka fee-for-service model) has functioned for decades, by rewarding providers for the volume and complexity of services they rendered. Unfortunately, this method has been criticized for leading to excessive workups and testing for financial gain. Therefore, in order to more effectively control physician reimbursement, the Congress created the Physician Payment Review Commission in 1986. By 1992, the resource-based relative value system (RBRVS) was begun by Medicare and maintained the physician payment expenditures in a budget-neutral fashion by creating a financial conversion factor. RBRVS accounted for physician work, practice expense, professional liability, and geographic factors [1]. Although this system was equitable in rewarding physicians for the amount of care provided, it was inadequate to address quality of care, a concept that was developing at the same time.

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Author information

Authors and Affiliations

  1. Department of Surgery, Mercer University School of Medicine, Memorial University Medical Center, Savannah, Georgia, USA

    Brett Tracy MD

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  1. Brett Tracy MD
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Correspondence to Brett Tracy MD .

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Editors and Affiliations

  1. Department of Surgery, University of Utah, Salt Lake City, Utah, USA

    Mark Savarise

  2. Department of Surgery, Mercer University School of Medicine Memorial University Medical Center, Savannah, Georgia, USA

    Christopher Senkowski

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Tracy, B. (2017). Pay for Performance and Value-Based Care. In: Savarise, M., Senkowski, C. (eds) Principles of Coding and Reimbursement for Surgeons. Springer, Cham. https://doi.org/10.1007/978-3-319-43595-4_10

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  • DOI: https://doi.org/10.1007/978-3-319-43595-4_10

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-43595-4

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