Payment Reform

Imagine an orchestra filled with providers and plans each playing its own tune to move towards value-based payment to incentivize better care and health. Alone, each tune is recognizable. But without working together, cacophony abounds. Enter the state as conductor and participant in aligned multi-payer payment reform, and sweet sounds emerge. If it only happened […]

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  • State Health Policy Blog

    Okay, maybe as a California colleague suggests, it’s one of the “boutique states” and yes, its single payer plan stumbled, but don’t take your eyes off Vermont. Vermont is at work to hold down costs and reform payment and delivery systems. The Green Mountain Care Board (GMCB) is engaged in comprehensive efforts to control health […]

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  • Many states are developing and implementing payment reform initiatives to help improve the patient experience and the health of populations while lowering the costs of care.  Payment reform efforts involve a transition away from fee-for-service (FFS) payment mechanisms that reward high volume to alternative payment methods that reward value. Such payment models include shared savings, […]

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    March 5, 2015 | Filed under: Payment Reform
  • Webinars

    Friday, February 27, 2015: Many states across the nation are in the process of designing and implementing multi-payer payment reform initiatives. The goals of these initiatives are to improve patient experience, improve the health of populations, and reduce health care costs. This webinar addresses how current payment reform models can help fix our broken health care delivery system and assist states to achieve the Triple Aim. However, along the payment transformation journey, are there potential pitfalls of payment reform models that states should look out for and avoid?

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    February 3, 2015 | Filed under: Payment Reform, Webinars
  • Webinars

    Monday, December 15, 2014: This panel-style webinar features a discussion with representatives from a commercial plan, a self-insured purchaser, a large health system, and a primary care provider. Panelists discuss their interaction with state delivery and payment transformation as well as their goals and motivations for participating in such efforts. The webinar audience learns about the unique challenges that each of these stakeholders face in implementing state health system reforms and the ways in which states can better collaborate with payers, purchasers, and providers.

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    December 3, 2014 | Filed under: Payment Reform, Webinars
  • State Health Policy Blog

    Low birth weight and preterm birth carry substantial human and financial costs; they also are associated with health problems that can have long-lasting effects. Renewed state and national commitment to improving birth outcomes and the quality of maternal and infant care are evident in states across the country as well in federal initiatives such as […]

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  • Webinars

    Tuesday, July 29, 2014: This webinar explores the leap from health system transformation planning to practice by showcasing four leading states that are designing and implementing multi-payer payment reforms. Through a facilitated discussion, state officials discuss policy levers to shift payment systems away from fee-for-service, offer strategies for sustaining stakeholder momentum and commitment, and share perspectives on promising practices for and operational challenges of turning a plan for multi-payer payment reform into reality.

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    July 15, 2014 | Filed under: Payment Reform, Webinars
  • Publications

    Public payers are moving to implement payment strategies that reward value in the health care system by linking payment to quality. This report—the third in a series supported by The Commonwealth Fund to explore opportunities for improvement in federal and state policy— highlights quality measurement strategies underpinning value-based purchasing initiatives at the federal and state […]

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  • Publications

    Increasingly, states are relying on managed care delivery systems to serve Medicaid enrollees that have historically been exempt from enrollment in managed care, such as children and youth with special health care needs (CYSHCN). The federal Medicaid managed care regulations establish the broad requirements for states to identify and assess individuals with special health care […]

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  • Publications

    The federal government and states are exploring new strategies for rewarding value in order to achieve better health outcomes at a lower cost. This report—the second in a series supported by The Commonwealth Fund to explore opportunities for improvement in federal and state policy— highlights relevant policy levers that can support payment reform and a […]

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    October 31, 2013 | Filed under: Payment Reform, Publications