The Upfront Pricing Phenomenon | Out-Of-Pocket

Those are promising signs. On the other hand, the fundamental economics of the value-based arrangement still aren’t clear. If fee-for-service turns out to more profitable for both payer and provider, then value-based care won’t survive outside of Medicare Advantage. And there have been failures in the past, as cited above.

These arrangements differ from the more common ‘fee-for-service’ model, in which the insurer is billed for each service rendered by the provider. Under this arrangement, the insurer is the one bearing nearly all financial risk.

Challenge #3: Lack of price transparency and increasing costs of healthcare

- Be cost-conscious. Care is getting wildly expensive. Primary Care 3.0 should use data to recommend the least expensive way to diagnose and treat, and manage over time 95% of general health issues.