Healthcare Payment System For Value-Based Reimbursement Can Address Many Challenges



There are many stages to healthcare when a person goes to a doctor. After the consultation, the person has to get tested or scanned, and then go back for a follow-up, where he or she might be directed to a specialist, which in turn would result in additional consultations. Organizations like blood test and radiology labs, physiotherapy centers, private practices, and hospitals must fill out different kinds of information to get reimbursement from insurance payers.



Having an integrated digital healthcare payment system helps the providers, payers, and most of all, the patients. These platforms streamline the entire process of healthcare payment processing and provider more options for patients to pay at per their convenience. Moreover, provider organizations could also curate such systems to their requirements for optimizing existing workflows.





Whether it’s a pharmacy, psychiatric facility, assisted living facility, nursing home, veterinary clinic, a hospital, or an outpatient ambulatory care center, a digitized payment system integrated with the existing health system helps them receive payments that fit in with their established procedures. In an era of rapid adoption of digital technologies, the ability to integrate a payment system with EHRs, mHealth applications, and telemedicine solutions allows providers and patients greater flexibility to receive and make payments respectively.


Improving patient experience doesn’t just begin and end with the quality of care. It is the quality of the overall time with the healthcare professionals that matters. If a patient can access his or her health information such as vitals, diagnosis, reports, and treatment options on the same platform as he or she can make payments, it is bound to leave the patient with a positive overall experience. The payments can be made, verified, as well as tracked on the same interface with a few clicks. Providers too can track each health care payment better, which helps small practices manage their finances more efficiently.


The spending on healthcare in America functioned on a model called the fee for service model. As the name indicates, it paid providers on the basis of the number of services rendered. This would include every consultation, test, scan, and so on. Unsurprisingly, it incentivized providers to focus on the number of services, as opposed to their quality. But after the pandemic, more and more people, as well as policymakers, wanted to shift to value-based payment systems. As the name indicates, it reimburses providers on the health outcomes of the patients. In other words, it gives patients value for the money spent on medical care. 


Health care payment systems that can adapt and evolve for value-based healthcare are an immediate necessity. Providers have been reluctant to adopt this model of payment, but increasing pressure from policymakers and the American people seems like they might accelerate the switch over to value-based reimbursements. If patients feel like they can make payments using their smartphones or credit cards for the value of care received, it would definitely usher in a much-needed change in healthcare in the United States and help cut down the spending which has exceeded $4 trillion. 


The case for newer payments software solutions to support value-based care has never been stronger.

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