After years of discussion, fee-for-service payment models are finally being challenged in a real way. With value-based care, providers are reimbursed based on patient health outcomes instead of number of patients they see. Value-based care needs vendors as well as providers to operate differently. But these new revenue models and the modern approach to hiring deserve special consideration.

Value-based care is gaining momentum:

Change is rarely instantaneous. The thought and the plans for value-based care have been around for over a decade. Like a new force that is meant to reshape an industry, change is slow. Infact, it is a bit slower in healthcare. However, ten years later, the impact of this fundamental shift has become difficult to ignore.

In 2017, 34% of U.S. healthcare payments, representing approximately 77% of the covered population, flowed through Alternative Payment Models and Population-Based Payments.

The 2019 Change Healthcare report states that the last five years saw a seven-fold increase in the number of states implementing value-based reimbursement programs; 48 states now have value-based programs.

Accelerating these shifts, Centers for Medicare & Medicaid Services (CMS) introduced new payment models to overhaul primary care, kidney care and Medicare Advantage and Part D plans in 2019, aiming to propel value-based care even further. This year, CMS also upgraded Medicare Advantage (MA) to reimburse for benefits that address social determinants of health- such as meal delivery or rides to the grocery store. Since, there have been numerous announcements of states, payers, and providers working to address social determinants in different ways-from affordable housing to GED assistance.