There is much buzz in the health care field about moving to a value-based purchasing/pay-for-performance system rather than a fee-for-service system. In other words, providers would be rewarded for how well they provide services and obtain better patient outcomes, not by how many services are provided, as is the current usual payment structure. This basic premise drove many of the provisions of the Patient Protection and Affordable Care Act (PPACA). It is this premise that is the root of the accountable care organization (ACO) idea, about which we have written several times.
While the federal government (and, more recently, some commercial payors) has pushed this idea of payment for performance, creating a lot of industry chatter, such a system is not meant to go in place all at one time or completely replace in the foreseeable future the current fee-for-service system. However, the federal government has now begun to take the first steps toward implementing payment for performance.
