Fee-for-Service Payment and Quality Oversight

Fee-for-service is the traditional health care payment model in the U.S. and is often described as the “chassis” upon which health care is organized, despite evolution in payment models over time. This course explores how fee-for-service payment works for professionals and hospitals, and the various mechanisms that exist to encourage quality when payment incentivizes volume of services. Learners will consider strategies to optimize both revenue and quality performance under fee-for-service payment incentives.

Learning outcomes for this course include:

1. List the essential components of documentation for fee-for-service billing
2. Discuss the incentives that fee-for-service payment creates for hospitals and providers billing for professional services
3. Identify 4 mechanisms used to hold providers accountable for quality in a fee-for-service system
4. Explain the limitations of currently available quality measures
5. Analyze 3 ways that performance on quality measures impact revenue for your organization
6. Identify 3 revenue and/or quality performance expectations that are commonly placed on health care leaders