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Payment Reform

Bending the Curve: Person-Centered Health Care Reform

"Our approach enables Congress to focus on overall cost, quality, and access goals that are very difficult to address under current law – so that whatever the spending level, that spending will do more for health."

Center for Medicare & Medicaid Innovation: Where Innovation is Happening

The Innovation Center was established by section 1115A of the Social Security Act (as added by section 3021 of the Affordable Care Act). Congress created the Innovation Center for the purpose of testing “innovative payment and service delivery models to reduce program expenditures …while preserving or enhancing the quality of care” for those individuals who receive Medicare, Medicaid, or Children’s Health Insurance Program (CHIP) benefits. The Innovation Center is currently focused on the following priorities:

State Innovation Model Testing Winning States

The Department of Health and Human Services launched the State Innovation Model (SIM) Testing Awards, providing up to $300 million to support the development and testing of state-based models for multi-payer payment and health care delivery system transformation with the aim of improving health system performance for residents of participating states.

The National Scorecard and Compendium on Payment Reform

"The results of the first annual Scorecard are in and 10.9% of all commercial in-network payments are value-oriented either tied to performance or designed to cut waste."

The Business Case for Bidirectional Integrated Care

The Integration Policy Initiative (IPI) was a collaborative project, led by the California Institute for Mental Health (CiMH), the California Primary Care Association (CPCA) and the Integrated Behavioral Health Project (IBHP). Participants in the IPI project coalesced around a vision: Overall health and wellness is embraced as a shared community responsibility 

Evolving Models of Behavorial Health Integration in Primary Care

The Millbank Report is a well-researched summary of the state of the evidence about integrated primary care. It reviews the different ways in which Behavioral Health and Primary Care can collaborate, discussed the pros and cons of each approach and made on how to approach integration in these challenging fiscal times. It provides specific suggestions for how to increase collaboration, lists possible incremental steps toward integration and factors to consider when selecting how best to implement integration into an individual practice.

National Strategy for Quality Improvement in Health Care

The National Strategy for Quality Improvement in Health Care (the National Quality Strategy) sets a course for improving the quality of health and health care for all Americans. It serves as a blue print for health care stakeholders across the country – patients, providers, employers, health insurance 

Infographic: Why the Medical Home Works

The PCPCC has developed the following framework to help fellow medical home supporters and advocates explain the benefits and strategies associated with delivering patient-centered primary care. The graphic is organized according to the five key features of the medical home model: Patient-centered, comprehensive, coordinated, accessible, and committed to quality and safety.

The infographic includes definitions for each of these features, sample strategies used by health professionals, employers, and payers, and their collective impact on the health system.

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