Developing a Value-Based Care Model for Neurology

Provider reimbursement today is primarily based on a fee-for-service (FFS) reimbursement model. The primary benefit of FFS is that it is simple to understand and operationalize. In FFS, the physician provides a service, bills for the service, and is paid for delivering the service. Although FFS is simple to implement, it has contributed to our current cost crisis in health care. Value-based care is a proposed solution to decrease costs and improve outcomes; however, the move from FFS to value-based care has been slower than expected. Among the primary reasons is the complexity of designing a reimbursement model that supports and incentivizes value-based care. It is unrealistic to expect providers to improve quality and lower cost if the payment system does not support their efforts. For neurology, the FFS model leaves proactive high-value services to prevent disease and complications undercompensated and creates an environment where reducing avoidable spending can decrease provider revenue. As we continue to struggle with high-cost health care producing suboptimal outcomes, we need to continue to push for value-based payment reform.