Navigating Next Steps on Payment Reform

The Alliance for Health Policy, in partnership with the JKTG Foundation, hosted a panel discussion to provide an update on the overall state of play with payment reform, and the effort to move away from fee for service and toward value-based payment. Panelists discussed the interplay between the public and private sectors, and, given the likely future for the CMS Center for Medicare and Medicaid Innovation, highlighted areas where the private sector may be best positioned to lead. Panelists also shared what this means for future policy options and needs.

Sarah Dash, of the Alliance for Health Policy, moderated the panel discussion.

Panelists: 

  • Rob Saunders, Duke-Margolis Center for Health Policy
  • Emily Roesing, Cataylst for Payment Reform
  • Mai Pham, Anthem
  • Allison Stark, Montefiore Care Management

 

SUMMARY OF REMARKS

Rob Saunders, research director, payment and delivery reform, Duke-Margolis Center for Health Policy

Key takeaway: The goals of payment reform are to incentivize care redesign that prioritizes high quality, high value health care, encourage better coordination of care and make coverage more affordable and spend money more wisely through new care approaches.

Emily Roesing, director of business development, Catalyst for Payment Reform

Key takeaway:Employers are critical to health care innovation because they buy health care on behalf of millions of employees. As costs have continued to increase, employers are spending more money and often getting less back. This impacts costs and the health of their employees; employers have a clear interest in investing in higher-value models of care.

Mai Pham, vice president, provider alignment solutions, Anthem

Key takeaway: For the past 5 or 6 years there has been a lot of work done by policy makers, the private industry, etc. to build a lot of momentum in the marketplace we are currently in. Right now, some actors in the marketplace are starting to question that momentum and are wondering whether or not to continue down this journey.

Allison Stark, vice president and chief medical officer, CMO Montefiore Care Management

Key takeaway: The best ways to be a successful ACO is to have an overarching vision of population management, strong governing structure to support the provider community, evaluate and understand your patient population, develop an ongoing care and population management organizational strategy and leverage new technology.


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The Alliance is grateful for the support of the Jayne Koskinas Ted Giovanis Foundation for making this event possible.