What is the main problem with fee-for-service?

• A. Underutilization of services
• B. Patients pay out of pocket only
• C. It discourages innovation
• D. Encouraged unnecessary tests/procedures (volume over value)

Answer: (D)

Fee-for-service pays providers for each service delivered, so the financial incentive is to maximize the number of services performed rather than to maximize patient outcomes or overall value. This creates a tendency to order more tests, procedures, and visits—even when they may not be strictly necessary—driving higher costs and potential patient harm without clear improvement in health. In contrast, models that reward value or outcomes aim to align payment with the quality and efficiency of care, reducing unnecessary interventions. So the main problem is the volume-over-value incentive that can lead to overutilization.