The healthcare delivery system traditionally has adhered to a fee-for-service model. Physicians are paid based on quantity, not quality, of treatments, which some observers say has led to a decline in the value of care and a rise in healthcare costs.
Horizon Blue Cross Blue Shield of New Jersey, recognizing that this system was financially unsustainable and didn’t reward care quality, decided to turn the old model on its head. Its efforts to move to a fee-for-value model followed the launch of the Affordable Care Act (ACA) and the start of healthcare reform. The organization’s CIO, Doug Blackwell, calls the effort a strategy to hit the “triple aim.”
“It’s really getting into three different components,” Blackwell explained. “The first is the overall improvement in the quality of healthcare, the second is improvement in the total cost of care, and the third is enhancing the patient experience.”