Stakeholder Engagement and Pilot Convening

States that are seeking to build multi-payer programs have critical roles to play in engaging payers and providing antitrust protection, engaging and contracting with providers, and partnering with other key stakeholders, such as consumers.

Please also see the Forming Partnerships section of NASHP’s Medical Home Map and the Authority and Governance sections of NASHP’s State Accountable Care Activity Map.

 

Engaging Payers and Navigating Antitrust Issues:

  • Townley, Charles, and Rachel Yalowich. 2013. “Five Key Strategies to Engage Health Care Payers and Purchasers in a Multi-Payer Medical Home Initiative.” National Academy for State Health Policy.Identifies five overarching strategies that states convening multi-payer medical home initiatives can use to make a case for payer and purchaser participation: building trust among competitors; leveraging existing infrastructure; using the market to drive demand; striking the balance between flexibility and consistency; and illustrating the value of the model.
    building trust among competitors; leveraging existing infrastructure; using the market to drive demand; striking the balance between flexibility and consistency; and illustrating the value of the model. – See more at: https://nashp.org/publication/five-key-strategies-engage-health-care-payers-and-purchasers-multi-payer-medical-home-in#sthash.VYrSTTrK.dpuf
  • Cavanaugh, Sean, and Gregory Burke. 2010. “A Multipayer Approach to Health Care Reform.” United Hospital Fund.Makes a case for the value of multi-payer initiatives and identifies potential roadblocks. Describes various models for multi-payer initiatives and highlights potential leadership roles for states.

Engaging Providers and Provider Contracting:

  • Rhode Island Chronic Care Sustainability Initiative. 2011. “Chronic Care Sustainability Initiative Common Contract.”Common contract between all practices and payers participating in Rhode Island’s multi-payer medical home program, the Chronic Care Sustainability Initiative. Includes expectations around payment, quality metrics, and data sharing between practices, plans, and project management.

Engaging Consumers and Other Stakeholders: