BC Advantage - 2025 Issue 1

How Medical Coding Drives Value-Based Care and Better Patient Outcomes

Value-based care is reshaping coding and billing practices, including the role of quality metrics and risk adjustment in reimbursement.   As healthcare continues its shift toward value over volume, approximately 60% of healthcare payments in the U.S. are now tied to value and quality. However, while the phrase "quality care" is widely used, it is somewhat misunderstood. Value-based care provides a more precise definition.   The National Academy of Medicine defines value-based care as safe, timely, efficient, equitable, effective, and patient-centered -- STEEEP. While the traditional fee-for-service model rewards providers based on the volume of care, value-based care...

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