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Here's how UNC Health grew its population health infrastructure (despite a fee-for-service environment)


Medicare "fee-for-value" codes present an opportunity for providers still reimbursed under fee-for-service to fund investments in value-based care. However, these codes (e.g., TCM, CCM, ACP, BHI, AWV) are still heavily underutilized. A 2018 analysis found that despite demonstrating significant impacts on total cost of care and mortality, providers billed TCM in only 7% of eligible cases in 2015 (up from 3.1% in 2013). Similarly, a 2017 analysis found that only 4.5% of eligible providers billed CCM in the first 15 months of availability. And research published in JAMA Internal Medicine  earlier this year found that use of ACP codes is less than 3%.


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