With states increasingly moving to develop population-based payment arrangements with provider organizations, the critical role of safety-net providers has become a challenging consideration for states. While safety-net providers typically lack the capital, experience, and/or scale to operate as an Accountable Care Organization (ACO), their role in state Medicaid programs underscores their integral role in the implementation of a population-based payment strategy with ACOs.
Developing a State-based Quality Measurement Program Using an Episode-of-Care Framework: Recommendations for State Purchasers
In attempting to move toward value-based payments, there exist the inherent challenges posed by the availability of data. States wishing to accelerate the transformation of the existing delivery system into one that delivers high quality and affordable health care have to take action to develop a comprehensive data collection and reporting mechanism. Such an approach can be taken using episodes of medical care as the central unit of measure.
Federally Qualified Health Centers (FQHCs) traditionally provide health care services primarily to low-income individuals who are covered by Medicaid or who are uninsured. As state Medicaid programs increase their focus on value-based payment, it is important to consider how FQHCs may participate in payment reform strategies. This brief provides an overview of FQHC cost reporting, delves into state payment reform strategies that Include FQHCs, and offers considerations for states and FQHCs alike.
State health care purchasers are increasingly shifting toward value-based purchasing (VBP) strategies that reward providers for value or outcomes as a means of improving care, improving health and reducing overall costs. This webinar examines how states are currently advancing payment reform in their managed care provider networks by moving away from fee-for-service (FFS) and identifies key considerations for states interested in implementing VBP strategies in this environment. Representatives from Arizona and Tennessee share ground-level experiences in adopting VBP strategies in their Medicaid managed care programs.
This suite of issue briefs is geared toward states interesting in value-based purchasing for health care. Part 1 deals with strategic considerations, Part 2 offers an implementation guide, while Part 3 includes a planning template for state purchasers.
The final webinar in a three-part series on payment reform, this presentation by Bailit Health Purchasing addresses special topics in payment reform including using state levers to implement payment reform, multi-payer strategies, and measuring delivery system performance.
The second webinar in a three-part series on payment reform, this presentation by Bailit Health Purchasing describes payment reform models being used by state purchasers, including how they work and their strengths and challenges.
The first webinar in a three-part series on payment reform, this presentation by Bailit Health Purchasing addresses how traditional fee-for-service payment impedes state efforts to purchase value and describes the relationship between payment and delivery system reform.
This issue brief focuses specifically on the key purchasing strategies that state Medicaid agencies and state employee health benefit purchasers can implement in order to reduce the overuse and misuse of health care services, and improve the quality and reduce the cost of care. A webinar presentation on the subject is also available for download.