Want More Flexibility? Want Better Rates? Get The Performance Data

In serving consumers, clinical professionals want flexibility and often chafe at the “rules” put in place by payers and health plans. What services are reimbursable? How many services can be delivered? How to navigate prior authorization processes? How to manage documentation requirements? But as someone who came from the financial side of the health care system, the “rules” are intended to assure that appropriate services are delivered and to manage costs.

I see value-based reimbursement (VBR) models—particularly those that move away from fee-for-service—as a way to move toward more flexibility for provider organizations and their . . .