VBR = Scale = M&A

Moving away from fee-for-service (FSS) reimbursement has always given an advantage to larger, capital-rich provider organizations. And that advantage grows with increasing financial risk. Reimbursement arrangements based on FFS with performance bonuses and gainsharing require an enhanced level of infrastructure (see Is ‘Non-Traditional” A New Definition? and Collaborative Care At Scale – More Important Than Ever). But arrangements with performance penalties and/or downside financial risk (case rates or capitation payments) are a whole new ballgame from an organizational infrastructure and financial strength perspective (see The OPEN MINDS Value-Based Reimbursement Readiness Assessment Checklist and How To . . .