Payment Reform

Download Slides   States, in their capacities as payers, purchasers, and regulators, have a key role to play in shifting to payment structures that reward high quality care and reduce the volume incentives inherent in fee-for-service reimbursement. Payment reform, particularly when multiple payers work together, offers the potential not only for promoting value in health […]

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  • Publications

    As a result of large-scale changes in insurance coverage under the Affordable Care Act (ACA), financing streams for safety net providers will shift. The law provides significant resources for further development of some safety net providers while reducing funding streams for others. The vulnerable populations served by the safety net—poor and underserved communities—may not fundamentally […]

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    October 10, 2012 | Filed under: Payment Reform, Publications
  • State ‘Accountable Care’ Activity Map
    Maps

    With the support of The Commonwealth Fund, NASHP is tracking state efforts to lead or participate in accountable care models that include Medicaid and Children’s Health Insurance Program populations. Accountable care models aim to address lack of care coordination and wide disparities in cost and quality of care in the U.S. health care system, perpetuated […]

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    September 26, 2012 | Filed under: Delivery System Reform, Maps, 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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    August 21, 2012 | Filed under: Payment Reform
  • 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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