Part of the explanation as to why FFS is bad, and why VBP is good, is somewhat valid, but it doesn’t tell the whole story. The narrative goes like this. FFS causes doctors to focus on quantity rather than quality. This push for more patient volume which causes shorter & rushed appointments. Shorter, rushed appointments induces a predilection to refer anything but the most routine problems to a specialist; thus freeing up the room for the next easy patient.
Without a doubt, the scenario described leads to fragmented care, less personal care, redundancy, lower satisfaction with primary care, potential delays in treatment and increased costs related to over-utilization of specialists and excessive testing. But is something as economically fundamental as FFS really to blame?
It all sounds very convincing, but the terminology is misleading – as is the cause & effect between FFS and the calamity described above. What these well-intentioned proponents of VBP are really implicating is not really FFS at all; but they would like us to believe that it is.