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

From Recovery to Prevention: APTA Report Charts New Course For Public Awareness

Oct 15, 2025

A newly released research report, APTA’s Consumer Perceptions Report, sheds light on how Americans perceive physical therapy — and where opportunities

News

APTA Advocacy Leads to Noridian Updated Guidance on Plan of Care Signature

Oct 14, 2025

On Sept. 10, the Medicare Administrative Contractor Noridian Healthcare Solutions amended its existing guidance on the regulations governing certification

News

FTC Drops Legal Appeals, Abandons Noncompete Rule

Oct 8, 2025

In August 2024, the United States District Court for the Northern District of Texas permanently barred the Federal Trade Commission's ban on employee noncompetes.