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	James L. Holly, M.D.

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Letters - Dr. Anwar, Dr. Wild, Fee-for-Servcie is Dead, Value-Based Payment Reform

Dr. Anwar is attending a conference in Las Vegas on Reducing Hospital Readmissions. Yesterday, April 27, he sent a note with a quote from one of the presentations given by Dr. Wilde, Chief Medical Officer (CMS) of Centers for Medicare and Medicaid Services (CMS), in which Dr. Wilde said: "Fee for service is dead. If you have a business plan that is based on fee for service then you need a different plan or start doing something else."

The transformation of payment methods for healthcare is being referred to as “Revenue Cycle Management”. As I noted yesterday, I was asked to given an address to Chief Financial Officers of healthcare organizations in Austin earlier this month. The attached articles address Value-Based Payment Reform. The articles are drawn from my responses to two sets of questions sent to me by the Chief Financial Editor of the Health Leaders Media. He wrote an article about the Austin Conference and is preparing a major, cover presentation for May or June of Health Leaders Media. The Editor send me a response to my Austin presentation which can be read at: http://jameslhollymd.com/Letters/response-to-dr-hollys-presentation-to-health-leaders-media, After reviewing my answers to his questions and after our telephone interview, the Editor said: “It is as I suspected, Dr. Holly: You and SETMA are ahead of the value-based payment model curve. Is there any area of healthcare reform you have left unexplored? You are an impressive reformist figure, with unique depth of experience. Eager to talk next week, Chris.” (emphasis added)

The two list of questions the Editor sent and my answers can be reviewed at the following hyperlinks:

Value-based Payment models, Last Group of Questions: http://jameslhollymd.com/Letters/value-based-payment-models-questions-for-the-industry-health-leader-media

Value-Based Payment Models, Questions for the Industry, HealthLeaders Media, Answers by James L. Holly, MD, April 2015 http://jameslhollymd.com/Letters/pdfs/value-based-payment-models-questions-for-the-industry.pdf

Eight questions about value-based payment models:

In the context of SETMA’s recent discussion about costs and fees in relationship to laboratory charges, this review of value-based payment reform and particularly the CMO of CMS’ statement are important for us to consider. Remember the CMO’s statement: "Fee for service is dead. If you have a business plan that is based on fee for service then you need a different plan or start doing something else."

James (Larry) Holly, M.D.
C.E.O. SETMA
www.jameslhollymd.com

Adjunct Professor
Family & Community Medicine
University of Texas Health Science Center
San Antonio School of Medicine

Clinical Associate Professor
Department of Internal Medicine
School of Medicine
Texas A&M Health Science Center

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