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

New ChoosePT Resources to Help You Educate Patients and Grow Demand

Apr 28, 2026

APTA's consumer-focused website, ChoosePT.com, continues to expand with new and regularly updated resources designed to help the public better understand

Article

New VA Scheduling System Eases Administrative Burden for Community Care PTs

Apr 28, 2026

Physical therapists providing care to veterans through the U.S. Department of Veterans Affairs Community Care Network are seeing long-awaited relief from

Article

CMS Requests Accelerated Medicaid Provider Revalidations: What PTs Need to Know

Apr 27, 2026

The Centers for Medicare & Medicaid Services has asked all state Medicaid agencies to conduct a "swift revalidation" of certain Medicaid providers identified