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

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

Feb 28, 2023 249 likes •335 views

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

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SLIDE 1

paying fo r what matters

@Pe te rL

  • ng BSCF
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SLIDE 2

f f

ation

tiere

Centers of Excellence

pay for performance

accountable care organization

capita

g

ed provid

Wellness trusts m

global budget Pricing

der netw

T h l A t

Pa yme nt Re form

medical

global budget

Bundled Payment

rence

works

Technology Assessment

value based insurance design home

Refe

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SLIDE 3

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

a mily F

  • unda tion - Me dic al Outc o me s S

tudy

y

y

  • Robe rt Wood Johnson F
  • unda tion - Pro me the us

De mo nstratio n De mo nstratio n

  • Commonwe a lth F

und - Me dic al H

  • me s, H

igh Pe rfo rming H lth C i i He alth Co mmissio n

  • Blue Shie ld of Ca lifornia F
  • unda tion - Bundle d Payme nts

Blue Shie ld of Ca lifornia F

  • unda tion Bundle d Payme nts
  • Blue Cross Blue Shie ld of Ma ssa c huse tts F
  • unda tion –

Pa fo r Pe rfo rmanc e pro grams Pay-fo r-Pe rfo rmanc e pro grams

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SLIDE 4

he alth c are will mo ve fro m paying fo r

l

t i f

l volume to paying fo r va lue

CURVE 1: F e e for Se rvic e

  • re info rc e s wo rk in silo s

c e

CURVE 2

  • all abo ut vo lume

CURVE 2: Va lue - ba se d Pa yme nt

e rforma nc

CURVE 1

CURVE 2: Va lue ba se d Pa yme nt

  • Re wards inte gratio n,

quality, o utc o mes & e ffic ie nc y

Pe

Na tura l tra je c tory

f ? f ?

T ime

Ho w far? Ho w fast?

SOURCE : Ia n Morrison’s “two- c urve fra me work” a s fe a ture d in Navigant Pulse F a ll 2011

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example s in te c hno lo gy asse ssme nt p gy

Ca lifornia T e c hnolog y Ca lifornia T e c hnolog y Asse ssme nt F

  • rum (CT

AF ) Compa ra tive E ffe c tive ne ss Public Advisory Counc il (CE PAC) (CE PAC)

Cre dit: Sta rtUp He a lth

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SLIDE 6

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
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SLIDE 7

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? Wh t th i t l f f d ti ? Wha t a re the a ppropria te role s for founda tions? 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 i f ?

  • ve r wha t time fra me ?

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?