Payment Reform to Support High-Performing Practice

Dozens of medical home demonstration projects across the country are exploring ways to implement better care coordination, meaningful use of health information technology, better communication access between patients and providers and a team approach to care. But efforts to transform health care delivery depend heavily on introducing sustainable new models to finance the medical home. Without changing the way health care is purchased, providers will have no incentive to move away from a system that promotes health care volume to one that rewards health care value. 

This report by the PCPCC’s Payment Reform Task Force reviews the spectrum of payment models currently being used to support PCMH implementation. By focusing on payment reform, its goal is to help guide those interested in financially sustaining the medical home model. The Task Force examined representative payment reform models and, in doing so, also derived a set of basic payment principles and guidelines. It is important to note that this work is not final; like the medical home itself, payment models are still in the development stage and evaluations of their effectiveness will likely shed more light on the topic.