With a lot of uncertainty about the future, hospital leaders are asking: What’s the best way forward? How do I succeed in today’s fee-for-service system while preparing for — but not getting too far ahead of — value-based payment?

The question has become more pressing since the Centers for Medicare & Medicaid Services and leading payers and providers announced ambitious value-based payment goals. The new goals increase the pressure on hospitals to change, but leave uncertainties about when and how to transition, especially at a granular level.

Fortunately, there are steps hospitals can take that will help to improve performance now, even in a fee-for-service environment, while preparing them to assume risk in value-based payment models. These steps generally focus on understanding underlying cost structures; managing variation in cost and quality; and delivering predictable, transparent outcomes. Unfortunately, the business model of health care has not valued these elements so, for most health care executives, this is foreign territory.

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