What Are

Home » Medicare Resources » What are Value-Based Providers?

Healthcare companies are often modeled one of two ways: fee-for-service or value-based. Both refer to the way providers are paid. Knowing whether your primary care physician follows the fee-for-service model, or the value-based model can make a huge difference in your level of care. What is the difference between the two and why is that important?


Fee-for-service is the traditional model in terms of how physicians are paid and approximately 70% of providers still use this model. This means that healthcare providers get paid based on how many services are performed. These services could include in-office exams, surgical procedures, tests and more. But what does this mean for Medicare beneficiaries? Essentially, healthcare providers are paid according to the number of services they provide or tests they run. This could mean being shuffled out of the office to make time for the next patient. Fee-for-service puts an emphasis on the quantity of services provided rather than quality of care.

Seeing a physician that follows a fee-for-service program means that you may be paying more money for a doctor to run potentially unnecessary tests or services in order to find an answer to any medical issues that arise.

Value-based providers

In contrast to fee-for-service based plans, value-based programs incentivize physicians by paying for the quality of care provided over the quantity of services. The goal is to keep patients from getting sick, instead of only treating patients once they are sick.

Value-based care plans allow medical professionals to be rewarded when focusing on the individual needs of each patient. Why is this important? If value-based providers are not paid due to the number of services provided, then they can spend time focusing on preventative care that allows beneficiaries to stay healthy and out of the hospital. Not to mention, the focus on preventative care often leads patients to spend less money out-of-pocket.

Are You Eligible for a Medicare Advantage Plan with Additional Benefits?
Get a Free Quote from a Licensed Insurance Agent.

Enrollment Eligibility

Annual Enrollment Period (AEP)

Medicare Annual Enrollment Period runs each year from October 15 to December 7. What is the Annual Enrollment Period vs. Open Enrollment Period?

Initial Enrollment Period (IEP)

Your Initial Enrollment Period generally surrounds your 65th birthday but may occur if you otherwise become eligible for Medicare for the first time.

Special Enrollment Period (SEP)

You may be eligible if you experience a qualifying life event such as moving to a new zip code, losing employer coverage, or change in Medicaid status.

Speak to a Licensed Insurance Agent Today

1-800-991-4407 / TTY 711

Mon-Thu 8am-11pm, Fri 8am-9pm EST

Aetna® Anthem® Cigna Healthcare® Humana® UnitedHealthcare®

e-TeleQuote Insurance Inc. (“e-TeleQuote”), an affiliate of Primerica, Inc., does business as easyMedicare® in all states other than California, Florida and New Mexico. e-TeleQuote is a duly licensed insurance agency appointed by Medicare Advantage HMO, PPO and PFFS plans and stand-alone prescription drug plans and insurance companies holding Medicare contracts approved by The Centers for Medicare & Medicaid Services (CMS). e-TeleQuote is not connected with or endorsed by the U.S. Government or the Federal Medicare Program. Enrollment in any plan for coverage is subject to insurance company approval. Enrollment in the plan depends on the plan’s contract renewal with Medicare. By using e-TeleQuote’s easyMedicare website, you understand and agree that in California, Florida and New Mexico, we operate as e-TeleQuote Insurance, Inc. (Your IP address and/or location coordinates may be gathered to verify your location.) Sales agents/producers may be compensated based on your enrollment in a health plan. Medicare Supplement plans are not connected with or endorsed by the U.S. Government or the Federal Medicare program. e-TeleQuote complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, or religion. easyMedicare.com is a non-government site, powered by e-TeleQuote Insurance, Inc. e-TeleQuote provides a secure way to purchase Medicare insurance from the comfort of your home or workplace. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options. To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.