Volume-Based vs. Value-Based Reimbursement Models in OT

Reimbursement models, in healthcare and business in general, incentivize specific behaviors. The reimbursement model you work under will directly influence what is expected of you. Once you have a better understanding of the incentive structures, you can work better within that structure. That’s why this week on The Amplify OT Podcast, I am talking about volume-based vs. value-based reimbursement models.

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In this episode, I cover:

• Historically, the United States has leaned closer to a volume-based care system, only adopting value-based care alongside the Affordable Care Act of 2010.
• Pros and cons of volume-based and value-based care models.
• Fee-for-service (volume-based) can be compared to shopping at a grocery store and paying a specific price for each item you buy. 
• Less common for OT practitioners, Capitated payments (value-based) can be compared to a gym membership where you pay a set dollar amount per month regardless of how many times you go to the gym. 
• Bundled payments (value-based) are like getting a paycheck where a certain amount goes towards paying necessities like bills and groceries and the rest is up to you to spend as you choose. 

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Want to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!

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LINKS MENTIONED IN THIS EPISODE:

• Reimbursement Models in OT: Do You Know What They Are? [Blog]
• How Understanding PDPM in Skilled Nursing Facilities Can Make You a Better Clinician [Blog and Podcast Episode]
• Sign Up for the Amplify Therapy Summit

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Mentioned in this episode:

Join the Amplify OT Membership

As a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It’s time to become your own best resource on Medicare and advocacy.

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