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October 25, 2022

A hospital room with empty beds due to reduced hospital readmissions under value-based care.
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The Great Transition: Adopting Value-Based Care Models

In recent years, there has been a push for healthcare systems to move away from the traditional fee-for-service model and instead focus on providing value-based care.  This shift is being driven by several factors, including the increasing cost of healthcare, the need for better coordination of care, and a desire

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Profit Calculator Assumptions: 40% of total Medicare patients enrolling is based on (i) Medicare Chart Book’s data showing that ~68% of medicare patients qualify for CCM (2 or more chronic conditions), and (ii) that ~40% of eligible patients will enroll.

For typical providers, $46.67 of net profit per patient per month is based on a Medicare reimbursement per patient per month (national average) for various care management CPT codes.

CPT and other codes, descriptions and other data are copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).