One of the key elements of Health Care Reform includes reforming the delivery of care and the methods by which that care is paid for. Payment reform will undoubtedly be one of the key issues the hospitals grapple with over the next several years. It is likely that over the next several years, the way in which payments are made for the commercial population as well as Medicare and Medi-Cal will change. This may include bundled payments for entire episodes of care, changes in billing or collection practices, or new payment methodologies. The Payment Reform Workgroup will discuss and provide key input to CHA on all payment reform issues.
The Catalyst for Payment Reform (CPR) released a report yesterday examining tools available to consumers and employers for determining health care pricing information. The report looked at fee-based online tools and telephonic price transparency products available from independent vendors for purchasers and employers, as well as the tools the major national health plans offer freely to their members. CPR’s report found that such tools have improved in recent years, allowing consumers to find information on both price and quality. The report also found that, while 98 percent of health plans claim to offer cost calculators, only 2 percent of patient members use them. The report concluded that price transparency tools can improve with additional data from plans and providers, and that consumers should be encouraged to use the tools at their disposal in order to avoid unneeded care and choose cost-effective care options. CPR’s report is available at www.catalyzepaymentreform.org/images/documents/stateoftheart.pdf.
The Centers for Medicare & Medicaid Services (CMS) will host a national provider call on hospital value-based purchasing (VBP) Feb. 28, 10:30 a.m.-noon (PT). The call is designed to help providers interpret hospital-specific performance reports. CMS is working on creating simulations of each hospital’s impact under the fiscal year 2013 VBP program. The simulated reports will use hospital data from prior years to construct each hospital’s baseline period and performance period scores. A sample report will be discussed during the call to prepare hospitals for reviewing their own reports.
The Centers for Medicare & Medicaid Services will hold a series of Accelerated Development Learning Sessions featuring care delivery experts within and outside government who will discuss the Bundled Payments for Care Improvement initiative. The web seminars will provide an opportunity for hospitals and other providers to deepen their understanding of how to improve care delivery and population health, while reducing costs, by redesigning care within a bundled payment program.
The California HealthCare Foundation has issued the attached report on the findings of a review conducted to better understand current payment models and those likely to emerge in California and the rest of the nation. Health Care Payment in Transition: A California Perspective identifies and discusses a number of considerations and strategies that stakeholders, such as hospitals and other providers, should take into account as they plan to transition to new payment models in the future.