Tag Archives: Payment Reform

What Should We Conclude From ‘Mixed’ Results In Payment Reform Evaluations?

It is true that evaluation results of payment reform models so far are not cause for celebration, but there are some positive cost and quality results and lessons are accumulating that can inform the next set of program parameters, incentive structures, and tools to help clinicians succeed.

August 14, 2017

Moving The Needle On Primary Care: Covered California’s Strategy To Lower Costs And Improve Quality

Covered California, a state health insurance exchange, has taken advantage of its role as a purchaser to work with health plans and clinicians to implement policies to emphasize and enhance the role of primary care.

June 14, 2017

The Payment Reform Landscape: For Employers, Keep Pushing Ahead

Because they cover more people than Medicare and Medicaid combined, employers could have a great deal of power over health care system reforms. But they need to use it.

April 21, 2017

Let’s Stop Making Excuses For Egregious Medical Errors

We know how to eliminate medical errors, says the leader of a foundation in Pennsylvania. We just haven't shown the courage and conviction to do it.

June 21, 2016

State Options To Control Health Care Costs And Improve Quality

While the ACA contains several tools designed to control health care costs, the current political environment makes it unlikely that reforms will be achieved at the federal level in the near future. States, however, are well-positioned to take the lead on implementing cost control and quality...

April 28, 2016

English Developments In Value-Based Care: The Beginnings Of A Revolution?

English developments with value-based and ACO-like care in the NHS are less prevalent and much less well documented than in the US. Nevertheless, significant lessons are beginning to emerge, some of which may have relevance internationally.

March 16, 2016

Not Your Usual Suspects: Roles For State Agencies In PCMH Payment Reforms

State insurance departments, State Employee Benefits, and Public Health departments and agencies in collaboration with Medicaid, private payers, and other stakeholders have undertaken significant roles to strengthen multipayer PCMH efforts.

December 8, 2015

Physician Payment Reform In A Post-SGR World: Challenges Remain

Recent policy changes and announcements follow widespread calls to move from the current volume-based fee-for-service payment system to a value-based system that pays for patient outcomes rather than individual services. But there are major challenges to achieving that goal.

September 3, 2015

Dynamic Vision Is A Cornerstone Of State Payment Reform Initiatives

Faced with rising health care costs, states are designing and implementing payment reforms that fundamentally transform how the health care market provides and pays for services. Take for example Ohio and Oregon.

July 28, 2015

Arkansas Payment Improvement Initiative: Expanding Episodes To Other Clinical Areas

After the first year of implementation of the episodic payment component of the multi-payer Arkansas Payment Improvement Initiative (APII), the state has identified both successes and challenges.

May 19, 2015