How We Get Paid in Healthcare

Matt Lund (Chief Contracting Officer, UW Medicine) walks us through the models behind how we get paid at UW Medicine. He delineates the CMS (Centers for Medicare and Medicaid Services) methodologies for determining reimbursement amounts for different hospitals, clinics, and providers. Factors considered include the amount of medical education conducted, the amount of uncompensated care provided, complexity of procedures, and locality of the hospital among others. Matt explains the intricacies behind why we don't always get reimbursed at the amount for which we bill, adding examples of how providers can ensure we receive the best reimbursement for any care given. Finally, he considers fee-for-service and value-based care as we continuously move towards our financial and mission-driven goals. Music by Kevin MacLeod (https://incompetech.com/)