Payment Reform
Quality Field Notes features key lessons learned by regional Alliances of clinicians, patients, and payers in Aligning Forces for Quality communities as they work to transform local health care and provide models for national reform. The latest topic in this series focuses on regional collaboratives. Regional collaboratives provide unlikely partners—including purchasers, payers, consumer advocates, clinicians, and others—a neutral setting in which collective goals and actionable strategies can be established. For the past eight years...
Health care leaders in New Mexico, including employers and other key stakeholders, are finding creative ways to improve the state’s delivery system while managing overall costs. Together, these disparate groups are crafting ways to ensure that health care payments are tied to the value, and not the volume, of the services delivered. These efforts are led by the New Mexico Coalition for Healthcare Quality, one of RWJF’s Aligning Forces for Quality (AF4Q) communities, which has brought together providers, patients, employers and insurers to help improve regional health care...
Bundled payment models hold the promise of driving down health care costs while improving health care quality. As pilot projects have been conducted in the field, common barriers and themes have emerged, including administrative implementation hurdles, data and technology challenges, new emphasis on engaging patients in their care, and questions of whether true costs savings can realistically be achieved. This brief addresses the successes and challenges encountered in a recent bundled payment pilot project in Wisconsin, as well as the underlying transformative...
Health care payment reform is critical to employers and other health care purchasers looking to contain health care costs and get greater value for their spending. The current fee-for-service model can encourage unnecessary care, driving up costs as we pay for the volume of care instead of its value. Reforms aimed at the payment side of health care can cut waste and improve quality by changing providers’ incentive structure. At the same time, we need to focus on aligning incentives across consumers, health care providers, health care payers, and health care purchasers, which...
Health care providers are increasingly being paid based on the value of the services they provide instead of the quantity, in the hopes of both improving quality and controlling costs. Aligning Forces for Quality alliances have worked with physicians, hospitals, insurers, employers and other stakeholders to develop and implement systems to measure and publicly report performance.
Journalist Bruce Japsen examines how hospitals and health systems participating in the Wisconsin Collaborative for Healthcare Quality have embraced new payment systems that...
Employers are the largest purchasers of health care in the United States, insuring more than 55 percent of the population. Excessive, ineffective, or harmful care costs a typical employer between $1,900 and $2,250 per employee every year. The Aligning Forces for Quality (AF4Q) initiative in New Mexico, led by the New Mexico Coalition for Healthcare Quality, is bringing employers together to help lower costs and improve the quality of care in the state.
Through the AF4Q initiative, the New Mexico Coalition has engaged many of the...
Since 2010, The Wisconsin Collaborative for Healthcare Quality (WCHQ)—a multi-stakeholder alliance working to improve quality—and the Partnership for Healthcare Payment Reform (PHPR) have worked with other organizations in Wisconsin to support providers and health plans in experimenting with innovative payment models. As part of that work, PHPR created two pilot projects: a bundled payment for total knee replacement and a shared savings project for adults living with diabetes. However, uptake of the new bundled payment pilot and shared savings projects has been slower...
Across Maine, patient-centered medical homes and their community care teams are improving quality and patient outcomes while reducing overall health care costs. Funded in part by RWJF’s Aligning Forces for Quality (AF4Q) initiative, Maine’s Patient Centered Medical Home Pilot has a broad reach—not only coordinating patients’ care and serving as a reliable resource, but also linking patients to services like food banks and mental health case workers. Results from the medical home initiative include a 40 percent reduction in readmissions at one participating...
Health care costs are measured in trillions of dollars and typically illustrated on a national scale. This wide-angle view can be difficult to relate to and comprehend, but zooming in to look at the spending in one town offers a home perspective that people can understand. China, Maine, a small town with just over 4,500 residents, has started a ripple effect across the country and is spreading the word about the rising costs of health care and its impact upon municipalities.
Town manager of China, Maine, Dan L’Heureux, who is also a board member...