In our earlier discussion of value-based care, I made the case that O&P practices need to be ready: measure meaningful outcomes, tell a credible cost-and-quality story, and avoid becoming an unmanaged line item inside someone else’s bundle.
That conclusion still holds. But a recent Medical Economics article adds an important dose of realism: Value-based care has not replaced fee-for-service, and it may never fully do so. After two decades of experimentation, the US healthcare system is still built largely on fee schedules, volume-based billing, fragmented data, and incentives that make a clean transition to risk-based payment very difficult. The article describes the likely future as “incremental gains at best”—not a sudden replacement of fee-for-service.
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