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Prospective payment for primary care: lessons for future models
Prospective payment for primary care: lessons for future models
Realizing a vision for advanced primary care in the United States will require adopting new payment strategies. The predominant payment scheme under which primary care practices operate--and their primary source of revenue--is fee-for-service payment. However, fee-for-service is not structured to support or sustain a comprehensive primary care system. Prospective payment for primary care is an alternative payment model that can facilitate care delivery transformations to better manage population health. It offers practices a predictable source of revenue, independent of the units of traditionally billable services, and the flexibility to manage care within a budget to optimize outcomes for a population of patients. Earlier primary care prospective payment models, such as those commonly employed in the 1990s, offer lessons and insights for designing a prospective payment for primary care that will facilitate the delivery of comprehensive, coordinated, and patient-centered primary care.
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