Medicare fee-for-service improper payments down $15 billion since 2016

by Brian Murphy

Sometimes it feels like its been discussed ad nauseum—the transition from fee-for-service to pay-for-performance. It’s a tired line, and it’s fair to ask: When is it going to happen (if ever)?

But when you pull the camera back and see the big picture, a major change in how healthcare is delivered and paid for is going on, right now, right under our noses. A recent survey indicated that 75% of hospital executives were concerned about their financial viability without an effective COVID-19 treatment or vaccine. Grim news, and we hope that the forthcoming vaccines deliver on their promise, but the same survey also shows where the new opportunities for growth lie: “Looking forward, hospital executives report that digital and ambulatory strategies will play an even more significant role at most organizations. For instance, 31% of respondents said that competitive dynamics in their market had been affected as more consumers sought out care from retail-based clinics.”