Payment Reform

Payment reform refers to the transition from paying for health care based on volume, regardless of quality, to paying for health care based on value, or quality relative to cost.  Federal and state programs have instituted a number of programs aimed at reforming health care payment mechanisms.  Payment reform models include value-based purchasing, shared savings programs, and limiting or eliminating reimbursement for poor quality care, such as hospital-acquired infections and so-called “never events.”  Topics related to payment reform include:

• Care Coordination/Care Management
• Medicare Data Requirements
• Medicaid/CHIP Data Requirements
• Patient Safety
• Private Insurance Data Requirements
• Quality Measurement and Reporting
• Resource Use Measurement and Reporting