Finance transformation for healthcare: A structured model for planning and action

Abstract

With rising healthcare costs, payers are transforming the way they pay healthcare providers. Currently, there is much interest in value-based financing and accountable care models. However, finance transformation in healthcare goes beyond changing funding models. The way funds flow to providers and how patients share healthcare costs also need to be transformed to ensure an overall sustainable value-based financing system. A structured model of finance transformation in healthcare is proposed in this article supported by evidential review, which discusses several fundamental and critical factors affecting finance transformation and explores some strategies that could help sustain the new financing models. Hopefully, this model can serve as a useful guide to healthcare systems embarking on finance transformation for long term cost sustainability.