In an article published by the Healthcare Financial Management Association (HFMA), three PYA executives discuss the healthcare industry’s move toward a value-based care model. In their article, “Why it’s so essential for hospitals to embrace a value-based payment strategy,” Brian Fuller, Principal; Jane Jerzak, Principal; and Martie Ross, Consulting Principal, share their expertise about hospitals’ struggle for financial stability and the challenges today’s hospital leaders face, as institutions move away from a fee-for-service payment model.
HFMA has served healthcare finance professionals for more than 75 years. The national association is a not-for-profit organization that “advances healthcare by collaborating with other key stakeholders to address industry challenges and providing guidance, education, practical tools and solutions, and thought leadership,” according to its website.
Using taxonomy developed by the Health Care Payment Learning & Action Network (HCPLAN), Fuller, Jerzak, and Ross define “value-based care,” offer insights about failure with the model, and discuss the way forward for financial stability.
The authors write:
“To succeed in this challenging new world, hospitals will require new and, in all likelihood starkly different, strategies. And a key element of future success will invariably be participation in true value-based payment models involving upside-downside risk that enable hospitals to align more closely with consumers and thus reap the rewards of the models’ quality and efficiency….The choice for today’s hospital leaders is either to manage the decline of an industry or to pursue a different path that enables them to continue to effectively serve their patients and communities.”
Fuller, Jerzak, and Ross also delve deeply into the forces that are driving the shift from the outdated fee-for-service model to today’s value-based alternative pay models:
- Demographics
- Economic pressures
- New competitors
- Structural obsolescence
Additionally, they provide details about the four categories of payment provided by HCPLAN and give pros and cons for each.
The PYA article was published on the HFMA website in June 2023 and will be included in the September 2023 issue of hfm Magazine. Download a PDF of the article.
If you would like assistance with value-based care integration, strategic and business planning, provider network design, or any other matter related to healthcare compliance or strategy, our executive contacts are happy to help. You may contact them at the emails below or by calling (800) 270-9629.
