By OPEN MINDS Circle
Alternative payment methodologies (APMs) is an umbrella term used to describe payment models that focus on quality, cost of care, or both, rather than utilizing only pay-for-volume or fee-for-service (FFS) payment models. Within APMs there are two main categories of payments:
- Pay-for-performance (P4P) – A payment system that, in addition to existing FFS payments, offers financial rewards or penalties for meeting or failing to meet specific performance measures, such as quality, cost, and other benchmarks. Generally, under P4P models, a single metric or set of individual metrics are taken into account. Examples of P4P models include incentive payments for meeting quality measures such as medication adherence, follow-up after hospitalization, and screening for depression.
- Value-based payments (VBP) – A payment system that links payment to cost of care, usually with concomitant quality measures. There are a range of models, including episodes of care, case rates, population health management risk, and traditional capitation
This Market Intelligence Report Examines:
- State By State Methodology
- Overview of APM Models
- Future Trends