Coffee with Coker

Episode 2: The Shift to Value-Based Healthcare

  • May 31, 2018

Dr. Ellis “Mac” Knight joins Mark to discuss value-based healthcare and its impact on the healthcare industry. They cover financing as a driving force in the healthcare landscape and why it continues to become more complex with the shift from pay for service to value-based care.



Episode Synopsis

With budgetary pressures on Medicare and Medicaid, pay for performance and federal expectations for investment in technology without regard to costs, executives must continuously monitor the financing landscape. The most significant factor in healthcare reimbursement today is the industry-wide shift to value-based care.

So, what is value-based care? One of the more common buzz phrases in the healthcare industry, value-based care, is a shift in focus. For the past two decades, healthcare providers have focused their efforts on the volume of services they are providing, not on the quality of services they are delivering. The reason is simple: physicians were paid only for the volume of professional services.

In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed and ushered in a dramatic change in the way CMS will pay healthcare professionals. MACRA consolidated multiple pay-for-performance initiatives (PQRS, VPM, and MU) into two quality payment programs (QPPs), the Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models (APMs).

Dr. Knight and Mark provide their views on the move toward value-based reimbursement and the reality of healthcare for the past 15 years.


MACRA: What IS it?

White paper on Value-Based Reimbursement

White paper on MACRA

Connect with Dr. Knight on LinkedIn

Follow Dr. Knight on Twitter

Contact Information

Subscribe to our feed in Apple Podcasts, Google Play, or your preferred podcast provider. Like what you hear? Leave a review!

Not there? Let us know! We welcome all feedback from our listeners. Please submit questions on any of the topics we discuss or questions about issues in which you have an interest. You can also provide recommendations on topics for future episodes.


Join our email list!

Please subscribe for new updates

Contact us today for more information about our healthcare consulting services and learn how we can help your organization.

Contact Us