Payment Reform

Payment describes the targeted delivery system (e.g. fee-for-service or managed care) of the initiative and the design of the accountable care payment model.   Alabama As described in the 1115 Waiver Concept Paper, this initiative would utilize a payment model that includes capitation with care management payments (the transition period could include fee-for-service).   The […]

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  • Publications

    The National Academy of State Health Policy (NASHP) conducted a survey in the summer of 1999 of the 31 states known to be using financial penalties or incentives in their Medicaid managed care contracts. This paper is based upon information provided by the 28 states that responded and examines recent trends in the use of […]

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    June 7, 2012 | Filed under: Payment Reform, Publications
  • Webinars

    Medicaid payment reform is needed to drive delivery system change. Moving to value-based purchasing strategies, particularly for patients with complex health needs, makes sense. Historically, however, few Medicaid programs have succeeded inmoving safety net providers away from volume-based reimbursement. This Medicaid-only webinar discussed options and possibilities for safety net providers to participate in value-based payment […]

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    June 4, 2012 | Filed under: Payment Reform, Webinars
  • Publications

    As the movement to enroll Medicaid beneficiaries in managed care plans continues to spread, new populations and services are coming into the fold of managed care. Nearly three-quarters of the states are enrolling low-income adults and children into capitated managed care programs. More recently, some states have introduced managed care to other, more vulnerable populations […]

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    May 21, 2012 | Filed under: Payment Reform, Publications
  • Publications

    The US. health care environment is changing rapidly. As employers and public agencies have tried to control spending, more health care is provided through managed care organizations. This approach to delivering care has reduced hospital use and led to thousands of empty beds. It also has spurred provider collaboration, for example through hospital mergers, physician […]

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    May 16, 2012 | Filed under: Payment Reform, Publications
  • Publications

    This report highlights What states have been doing to reduce their expenditures on long term care while maintaining access to needed services. In our analysis of the major strategies employed by the states we found that they fell into several categories: (1) Delivery system activities include strategies to reduce or control the number of nursing […]

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  • Webinars

    Innovative payment models can support medical homes by decreasing the cost of care, incenting and rewarding quality over quantity, and enabling practices to invest in infrastructure and supports. Many leading states have learned from early initiatives and are moving forward with new payment models that to further drive system goals, including lowered costs, improved quality […]

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  • Publications

    This paper summarizes the results of a conference in Albany, New York in November 1994 that brought together representatives from the four current and former “all payer” rate setting states of Maryland, Massachusetts, New Jersey and New York. State-based prospective hospital rate setting has declined from its former position as “the center of the policy […]

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    April 25, 2012 | Filed under: Payment Reform, Publications
  • Webinars

    The Patient Protection and Affordable Care Act (ACA) provides many opportunities for states to engage employers in health reform implementation. States can educate employers about the small employer tax credit, include employer input as they design insurance exchanges, and involve businesses in implementing new small group rating rules. Terry Gardiner, National Policy Director of the […]

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    September 21, 2010 | Filed under: Payment Reform, Webinars
  • Many states were already experimenting with health reform even before the federal legislation passed. Learn how Minnesota and Massachusetts have taken significant steps toward multi-payer healthcare delivery reform, cost control, and improving the value of health care services. A presentation titled “Reforming Health Care Delivery Through Payment Change and Transparency: Innovations in Minnesota and Massachusetts,” […]

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    July 26, 2010 | Filed under: Payment Reform, Presentation