LSCU SPECIAL FEATURE: Into the Nexus – Anti-Kickback Statute (“AKS”) versus Value-Driven Health Care

Part 1: An Uncertain Future in a Dynamic Landscape

Fans of Star Trek will remember the scene from the 1994 movie “Generations” in which Captains James T. Kirk and Jean-Luc Picard meet each other in The Nexus: the old versus the new. As the need to reform the healthcare system becomes ever more urgent, a new Nexus has developed between the old legal and regulatory framework (i.e., the Anti-Kickback Statute) and new ways of incentivizing the system to reward improved patient outcomes (i.e., Value Driven Health Care).

Health care is changing, including the way in which payments, compensation, and value policies and procedures are being implemented. As one recent article notes, these “changes are moving healthcare from a fee-for-service reimbursement model to a fee-for-value payment and care delivery model [including the] passage of the Patient Protection and Affordable Care Act of 2010 (ACA).”