Most people agree that Health care has been volume-based over the past 50 years with not paying much attention to outcome which can actually be measured by a number of quality indicators versus value -based Medicine which is defined as outcome divided by the cost.

Value- based care removes any financial incentive to provide any unnecessary services which have no positive impact on the patient outcome. So value and outcome are linked together. This is in clear contrast of fee-for service care is changing into value-based reimbursement to encourage providers to deliver the best care at lowest cost.

Alternative payment methods such as ( Accountable Care Organization ACO), and Bundled payments by the end of 2016, by 2108 90% of the traditional Medical Payment will be linked to quality or value medicine delivered .Technology for sharing electronic Medical Records and Tele Medicine with remote patient monitoring

Then comes the issue of Physician Autonomy as small practices struggle with increased documentation demand for payment of services, thus forcing so many to be employed by hospitals. Some other physicians will be forced out of their private practice as they can not generate enough income due to lowered reimbursements and rising over head costs.

It would be imperative for those physicians in small practices to unite , collaborate for survival. We attempt to reach out to our colleagues going through these challenges on daily bases to join our network of ethical providers that care and advocate for our patients who are also the consumers that we have their trust. The best viable model will again be the Direct Care Medicine and will be happy to share our experience and help as many colleagues and fellow physicians as we can to give hope for both patients and physicians that if you do the right thing and keep doing it day after day, eventually , things will turn around and will be a win win for all.

So, the message from now on, Practice value not volume Medicine in any setting you are in!