paying fo r what matters @Pe te rL ation tiere Centers of - PDF document

ong BSCF paying fo r what matters @Pe te rL

ation tiere Centers of Excellence capita pay for performance f f ed provid Wellness trusts accountable care organization g Pricing der netw Pa yme nt Re form works m medical global budget global budget Technology Assessment T h l A t rence Bundled Payment value based insurance design Refe home

payment re fo rm: no t new fo r fo undatio ns payment re fo rm: no t new fo r fo undatio ns • Ka ise r F ounda tion - Me dic al Outc o me s S tudy y a mily F y • Robe rt Wood Johnson F ounda tion - Pro me the us De mo nstratio n De mo nstratio n • Commonwe a lth F und - Me dic al H o me s, H igh Pe rfo rming H He alth Co mmissio n lth C i i • Blue Shie ld of Ca lifornia F ounda tion - Bundle d Payme nts ounda tion Bundle d Payme nts Blue Shie ld of Ca lifornia F • Blue Cross Blue Shie ld of Ma ssa c huse tts F ounda tion – Pa Pay-fo r-Pe rfo rmanc e pro grams fo r Pe rfo rmanc e pro grams

he alth c are will mo ve fro m paying fo r t i f volume to paying fo r va lue l l CURVE 1: F e e for Se rvic e CURVE 2 • re info rc e s wo rk in silo s c e e rforma nc • all abo ut vo lume CURVE 1 CURVE CURVE 2: Va lue - ba se d Pa yme nt 2: Va lue ba se d Pa yme nt Pe • Re wards inte gratio n, Na tura l tra je c tory quality, o utc o mes & e ffic ie nc y T ime Ho w far? Ho w fast? f ? f ? SOURCE : Ia n Morrison’s “two- c urve fra me work” a s fe a ture d in Navigant Pulse F a ll 2011

example s in te c hno lo gy asse ssme nt p gy Ca lifornia T Ca lifornia T e c hnolog y e c hnolog y Asse ssme nt F orum (CT AF ) Compa ra tive E ffe c tive ne ss Public Advisory Counc il (CE (CE PAC) PAC) Cre dit: Sta rtUp He a lth

c hanges o n the ho rizo n c hanges o n the ho rizo n • CMMI • IOM IOM • Ma jor Purc ha se rs

questio ns to c o nsider questio ns to c o nsider Wha t a re the de sire d outc ome s of pa yme nt Wha t a re the de sire d outc ome s of pa yme nt re form? Wha t a re the a ppropria te role s for founda tions? Wh t th i t l f f d ti ? Do the se role s de pe nd on the type a nd size of the founda tion, or the type of re form? the founda tion, or the type of re form? Wha t is the a ppropria te le ve l of e vide nc e , a nd ove r wha t time fra me ? i f ? How c a n GIH fa c ilita te this c onve rsa tion in the How c a n GIH fa c ilita te this c onve rsa tion in the fie ld?