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American Association for Physician Leadership
American Association for Physician Leadership

Competition in Healthcare and Non–Fee-for-Service Revenue Arrangements

by Ronald B. Sterling, CPA, MBA

June 8, 2017


Summary:

The success of your practice/HCO will depend on how well you meet non-FFS requirements and also how well you compete with the convenience and cost of a clinic associated with your local pharmacy. Your plan to address these challenges relies on using technology, redesigning patient service methods, and continually monitoring results.



Abstract:

The Medicare Quality Payment Program and other non–fee-for-service (non-FFS) programs from a variety of payers pose new patient service and care challenges to practices and healthcare organizations (HCOs). Revenue generation is moving from completion of a patient encounter or procedure to sustained patient service excellence over a month, months, or even a year. Compensation for non-FFS arrangements may be based on a standard of performance or require your practice to develop innovative ways to serve patients and manage their health. Shared savings, care management, episode of care, and other non-FFS arrangements require new patient service strategies and tactics. Further complications are the specific scope of services and target patient populations from each payer and program.


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