The payment or reimbursement mechanism is the process through which a payer or purchaser pays a provider for delivering a set of agreed target outcomes in an outcomes based contract. The traditional fee-for-service approach, which incentivizes activity, is recognized to be ineffective in driving improvement.
A well-designed payment and reimbursement mechanism is necessary to reward innovative behavior by providers, encourage providers to focus on the priority health outcomes identified by the payer or purchaser, and discourage poor performance.
In part 5 of our 7-part series on Outcomes Based Contracting, you’ll learn about designing a payment and reimbursement mechanism:
- Payment mechanism
- Benefits of a successful reimbursement mechanism
- Key considerations for payments & outcomes
