[thallium205]

Typically what they do is pay one time for a particular "case". So if you came into the doctor's office consecutively for the same symptoms for a week straight, they'd treat that as an episode of care and pay it as if it's one visit.

Another strategy is to pay a flat rate for seeing a patient. So if they come in once or come in 20 times that month, they get paid the same.

For hospitals what they like to do is pay only on discharge events. So again if you had a 9 day stay vs a 2 day stay, it's the same. They particularly like this because the third party hospitalists and all outpatient care have a difficult time getting the discharge data out of the hospital system resulting in many denials from the payers.

This is by no means an exhaustive explanation of "value" based care.

[mjamilkowski]

Thanks for the great summary!