Skip to main content

Feature-ValueBasedPayment-1.png

Historically, the U.S. health care system has had different payment methodologies, depending on the care setting. Hospitals, skilled nursing facilities, and home health agencies typically have been paid under a prospective payment system model, while outpatient care typically has been reimbursed on a fee-for-service or discounted fee-for-service basis.

FFS, which has been used for decades, directs health care insurers to pay health care professionals for each intervention provided to the patient. (Discounted FFS, typically within managed care arrangements, calls for discounts on regular FFS fees when patients use in-network providers.) Critics of FFS — as described in the June 5, 2014, Forbes article "More Health Care Is Better Health Care: Myth or Reality?" — long have argued that it incentivizes health care professionals to provide and bill for the highest number of health care services per patient during each visit, even if the need for such services is not indicated.

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.


You Might Also Like...

News

APTA’s Report on Direct Access Is a Tool for Action

Jul 7, 2025

APTA’s latest advocacy resource helps members improve patient access, payment, and consumer awareness of direct access to PT services.

Feature

Physical Therapy's Role in Hospital at Home

Jul 1, 2025

Hospital-level care is moving into patients’ homes — and PTs are helping lead the way in this evolving model.

Feature

Beyond Borders: US Physical Therapists Working Overseas

Jul 1, 2025

How U.S.-trained PTs are helping to transform global health and the role of physical therapy therein.