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...

Article

Advocates, Leaders Drive Payment Momentum During APTA Payment Advocacy Summit

The APTA Payment Advocacy Summit brought together 450 physical therapy advocates, business leaders, and payment experts at a critical moment in APTA's

Article

Proposed 2027 Medicare Physician Fee Schedule: What PTs Need to Know, Part 1

The U.S. Centers for Medicare & Medicaid Services estimates that physical therapy codes could see an overall payment increase of 1-3% under the Calendar

Article

APTA Master Class Series Brings Immersive, In-Person Learning to PTs and PTAs

The physical therapy profession continues to evolve in response to new technologies, changing payment models, emerging practice opportunities, and shifting