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1 Center for Healthcare Quality and Payment Reform
https://chqpr.org/
The Center for Healthcare Quality and Payment Reform (CHQPR) is a national policy center focused on designing and implementing payment systems that support ...
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2 Intro to Payment Reform
https://www.catalyze.org/product/get-started-intro-payment-reform/
A health care payment reform program is a contractual arrangement between a health care purchaser or payer and a health care provider that utilizes an ...
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3 The Payment Reform Landscape: Overview | Health Affairs
https://www.healthaffairs.org/do/10.1377/forefront.20140206.037019
Payment reform typically lies at the intersection between health plans (or a government payer) and providers. This is where incentives can be ...
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4 Health Care Payment Reform Advocacy | AMA
https://www.ama-assn.org/health-care-advocacy/payment-reform
The Medicare payment system is on an unsustainable path, and the AMA is fighting for payment reforms that will preserve the viability of physician practices and ...
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5 Entering the Next Phase of Value-Based Care, Payment Reform
https://revcycleintelligence.com/features/entering-the-next-phase-of-value-based-care-payment-reform
APMs aim to get the healthcare system back to one that incentivizes just that – health. The models tie provider reimbursement to the value of ...
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6 The Impact of the Payment and Delivery System Reforms of ...
https://www.commonwealthfund.org/publications/2022/apr/impact-payment-and-delivery-system-reforms-affordable-care-act
Mandatory National Payment Reform Initiatives ... The Affordable Care Act introduced compulsory value-based payment initiatives through Medicare ...
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7 The Impact of Payment Reforms on the Quality and Utilisation ...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8833260/
Pay for performance (P4P): a payment system in which reimbursement for healthcare providers are linked, entirely or in part, to the performance ...
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8 Value-Based Payment - Center for Health Care Strategies
https://www.chcs.org/topics/payment-reform/
Summarizes practical steps that state Medicaid agencies can take to support health equity within payment reform efforts.
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9 Payment Reform for Better Value and Medical Innovation A ...
https://nam.edu/wp-content/uploads/2017/03/Payment-Reform-for-Better-Value-and-Medical-Innovation.pdf
Consistent with the goals set for Medicare, the LAN seeks to facilitate tying 30% of payments to APMs by 2016 and 50% by 2018 across the health ...
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10 Value Based Payment Reform (VBP)
https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_reform.htm
NYS proposes to allow its providers and Managed Care Organizations to voluntarily include Medicaid services and beneficiaries in CMS innovative payment models ( ...
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11 Health Care Payment Reform 101: What Is It? Why Pursue It?
https://www.shvs.org/wp-content/uploads/2014/11/Payment-Reform-101-Webinar-Series-What-is-it.pdf
Payment Reforms Used by State Purchasers ... June 24: Special Topics in Payment Reform: State ... All health care payment systems create incentives and.
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12 Medicare Payment Reform: Lessons Learned and ...
https://www.allhealthpolicy.org/medicare-payment-reform-lessons-learned-and-considerations-for-the-future/
Medicare payment reform aims to increase quality health care for Medicare beneficiaries and improve the program's financial sustainability.
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13 Payment and Delivery Reform - NACHC
https://www.nachc.org/focus-areas/policy-matters/medicaid-and-medicare/payment-and-delivery-reform/
For health centers, this can encompass all of the activities designed to best align health center payment with practice – allowing health centers to sustain ...
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14 CMS' Value-Based Programs
https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs
Value-based programs reward health care providers with incentive payments for the quality of care they give to people with Medicare. These ...
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15 Randomized trial shows healthcare payment reform ... - PNAS
https://www.pnas.org/doi/10.1073/pnas.2004759117
Under bundled payments, Medicare makes a single payment for all services related to a clearly defined episode of care. The payments are sometimes adjusted to ...
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16 Provider Payment Reform :: Altarum - Healthcare Value Hub
https://www.healthcarevaluehub.org/improving-value/browse-strategy/provider-payment-reform
Provider Payment Reform. Private and public payers are exploring new ways of paying healthcare providers (doctors, hospitals and others) to incentivize the ...
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17 Payment Reform Glossary - HealthIT.gov
https://www.healthit.gov/sites/default/files/playbook/pdf/payment-reform-glossary.pdf
There is growing national recognition that the current systems used to pay physicians, hospi tals, and other healthcare providers fail to en.
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18 Payment Reform - National Conference of State Legislatures
https://www.ncsl.org/documents/health/PaymentRTK13.pdf
Payment Reform. 2. Introduction. Payment Models. During the last 25 years, health care providers and payers have experimented with different payment.
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19 Better ways to pay for health care - OECD
https://www.oecd.org/els/health-systems/Better-ways-to-pay-for-health-care-FOCUS.pdf
An overview of traditional payment methods in health care systems. Note: The predominant method of payment ... sought to reform payment systems to encourage.
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20 What is payment reform? | athenahealth
https://www.athenahealth.com/knowledge-hub/value-based-care/Payers-are-Moving-Toward-Value-Based-Reimbursement
Healthcare quality reform efforts such as the Affordable Care Act (ACA) are moving the industry away from the long-standing fee-for-service reimbursement ...
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21 Aligning Value-Based Payments With Health Equity
https://jamanetwork.com/journals/jama/fullarticle/2795498
Although consensus about the need to reform payment policy around equity has grown, effective reforms must reconcile existing tensions ...
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22 Current & Emerging Payment Models | AHA
https://www.aha.org/advocacy/current-and-emerging-payment-models
Medicare · Inpatient Prospective Payment System (IPPS) · Outpatient PPS · MACRA & Other Physician Payment · Inpatient Rehabilitation Facility PPS · Home Health PPS.
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23 Health Care Payment Learning and Action Network - Health ...
https://hcp-lan.org/
The LAN Summit is the landmark payment reform event that brings stakeholders from across the health care landscape together to network, learn, and share ...
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24 Facilitators and Barriers to Payment Reform: - Bailit Health
http://www.bailit-health.com/articles/092713_bhp_rwjf_facilitators.pdf
Many believe this form of payment has contributed greatly to the ever-increasing costs of health care. Payment reform, which entails moving away from the fee- ...
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25 PhRMA Principles for Payment and Delivery System Reforms
https://phrma.org/resource-center/Topics/Value-Driven-Health-Care/PhRMA-Principles-for-Payment-and-Delivery-System-Reforms
Payment reform should rely on competitive market-based mechanisms to advance high quality, efficient health care and should support meaningful ...
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26 Primary Care Payment Reform Collaborative | DORA Division ...
https://doi.colorado.gov/insurance-products/health-insurance/health-insurance-initiatives/primary-care-payment-reform
Report on current health insurer practices and methods of reimbursement that direct greater health care resources and investments toward health care innovation ...
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27 Medicare Physician Payment Reform — Enhancing Incentives ...
https://www.nejm.org/doi/full/10.1056/NEJMp2106852
Models that hold organizations responsible for managing patients' total cost of care are an important tool for payment reform.
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28 Provider Payment Reform & Value Based Payment Guide
https://nhhealthcost.nh.gov/employer-resources/provider-payment-reform-value-based-payment-guide
Provider payment reform is a transition from traditional fee-for-service payment models to VBP models. Reform is occurring because of a widespread belief ...
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29 Primary Care Payment Reform Collaborative - Oregon.gov
https://www.oregon.gov/oha/HPA/dsi-tc/Pages/SB231-Primary-Care-Payment-Reform-Collaborative.aspx
The purpose of the initiative is to develop and share best practices in technical assistance and methods of reimbursement that direct greater health care ...
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30 From vision to design in advancing Medicare payment reform
https://www.brookings.edu/research/from-vision-to-design-in-advancing-medicare-payment-reform-a-blueprint-for-population-based-payments/
Applying site neutral payments to hospitals in non-participating health systems; Excluding hospitals in non-participating health systems from ...
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31 Payment Reform Series - PolicyLab
https://policylab.chop.edu/project/payment-reform-series
Reimbursement policy—or how health care providers are paid for the services they deliver—enables and guides health care delivery, creating incentives for ...
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32 Leveraging Payment Reforms to Transform and Expand Home ...
https://www.youtube.com/watch?v=ncbSTGWisxE
Duke Margolis
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33 National Commission on Physician Payment Reform | sgim.org
https://www.sgim.org/communities/advocacy/national-commission-on-physician-payment-reform
The National Commission on Physician Payment Reform was created by the Society of General Internal Medicine (SGIM) to assess how physicians are paid, ...
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34 Strengthening Primary Care Delivery Through Payment Reform
https://www.urban.org/research/publication/strengthening-primary-care-delivery-through-payment-reform
The Urban Institute teamed up with Catalyst for Payment Reform to explore how established and proposed payment methods and benefit design options work. We also ...
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35 Payment Reform | Primary Care Collaborative
https://www.pcpcc.org/topic-page/payment-reform
Medicare has been piloting various types of payment reform — ranging from pay-for-reporting to bundled payment — but the scale and spread of delivery models ...
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36 The Future of Value-Based Payment: A Road Map to 2030
https://ldi.upenn.edu/our-work/research-updates/the-future-of-value-based-payment-a-road-map-to-2030/
In 2015, Health and Human Services (HHS) Secretary Sylvia Burwell publicly committed CMS to tying at least 90% of traditional Medicare fee-for- ...
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37 How Are Payment Reforms Addressing Social Determinants of ...
https://www.milbank.org/wp-content/uploads/2021/02/Duke-SDOH-and-VBP-Issue-Brief_v3-1.pdf
payment reforms that fail to target nonmedical needs may be less effective in improving population health, advancing health equity, and lowering health care ...
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38 Medicare Value-based Payment Reform
https://rupri.public-health.uiowa.edu/publications/policypapers/Medicare%20Value-based%20Payment%20Reform%20Priorities%20for%20Transforming%20Rural%20Health%20Systems%20-%20Executive%20Summary.pdf
were designed to strengthen rural health providers and systems are now complicating ... The inclusion of rural providers in Medicare payment reform is.
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39 State Delivery System and Payment Strategies Aimed at ... - KFF
https://www.kff.org/medicaid/issue-brief/state-delivery-system-and-payment-strategies-aimed-at-improving-outcomes-and-lowering-costs-in-medicaid/
Common delivery and payment reform models used by state Medicaid programs include patient-centered medical homes (PCMHs), ACA Health Homes, ...
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40 Payment Reform - The Council of Insurance Agents & Brokers
https://www.ciab.com/market-intel/healthcare/payment-reform/
The national debate on healthcare is partly grounded in how to, and who should, pay for it. While stakeholders agree that everyone deserves access to ...
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41 Provider Payment Reforms for Improved Primary Health Care ...
https://openknowledge.worldbank.org/handle/10986/36189
Provider payment mechanisms do not reward the high-quality care provision and may incentivize bypassing of PHC for hospitals, exacerbating challenges presented ...
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42 Payment Reform and Opportunities for Behavioral Health
https://www.thekennedyforum.org/app/uploads/2017/09/Payment-Reform-and-Opportunities-for-Behavioral-Health-Alternative-Payment-Model-Examples-Final.pdf
Payment reform provides an opportunity to address the rising cost of U.S. healthcare. Shifting from volume-driven systems to value-oriented alternative payment ...
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43 A Roadmap to Accelerate National Value-Based Payment ...
https://healthpolicy.duke.edu/sites/default/files/2020-06/a_roadmap_to_accelerate_national_value-based_payment_reform_filing_in_the_missing_pieces.pdf
payers, health systems, and provider groups affirm the role of payment reform as a key method of controlling costs and improving care.
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44 SIM Key Strategies: Payment Reform - DHHS Maine
https://www.maine.gov/dhhs/sim/key-strategies/payment-models.shtml
One way the State hopes to impact high healthcare costs is by changing the incentives in the market and aligning costs with the relative value of healthcare ...
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45 Physician Payment Reform and Hospital Referrals
https://www.aeaweb.org/articles?id=10.1257/aer.104.5.200
These are similar to arrangements introduced by the recent health reforms to give physicians incentives to control costs. In a previous paper we showed that ...
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46 Randomized trial shows healthcare payment ... - MIT Economics
https://economics.mit.edu/sites/default/files/2022-08/pnas.2004759117.pdf
Changes in the way health insurers pay healthcare providers may not only directly affect the insurer's patients but may also affect.
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47 State Delivery System and Payment Reform Map
https://www.nashp.org/state-delivery-system-payment-reform-map/
Once a health home state plan amendment is in effect, CMS provides enhanced federal funding (90% service match for the six core services) for eight consecutive ...
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48 Payment Reform: Honing the Models and Pushing the ...
https://academyhealth.org/events/2014-10/payment-reform-honing-models-and-pushing-boundaries
Payment Reform: Honing the Models and Pushing the Boundaries ... AcademyHealth, with support from the Robert Wood Johnson Foundation, convened experts and ...
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49 Payment Reform (@PaymentReform) / Twitter
https://twitter.com/paymentreform
The Center for Healthcare Quality & Payment Reform helps design and implement innovative approaches to healthcare payment and delivery in regions across the ...
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50 Payment Reform | Department of Vermont Health Access
https://dvha.vermont.gov/initiatives/payment-reform
The Payment Reform Unit within DVHA seeks to transition Vermont Medicaid's health care revenue model from Fee-for-Service payments to value-based payments ...
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51 Catalyst for Payment Reform Finds Value-Based Healthcare ...
https://www.hcinnovationgroup.com/policy-value-based-care/alternative-payment-models/news/21117305/catalyst-for-payment-reform-finds-valuebased-healthcare-not-moving-quickly-enough
Over that time, there was an early investment in pay for performance (12.8 percent of payments in 2014), but by 2016 shared savings payment ...
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52 CalAIM Behavioral Health Initiative - DHCS - CA.gov
https://www.dhcs.ca.gov/Pages/BH-CalAIM-Webpage.aspx
The CalAIM Behavioral Health Payment Reform initiative seeks to move counties away from cost-based reimbursement to enable value-based reimbursement structures ...
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53 Voluntary Regulation: Evidence from Medicare Payment Reform
https://academic.oup.com/qje/article/137/1/565/6372924
Proponents argue that by providing a single, fixed reimbursement, bundled payments will improve coordination of care and reduce unnecessary healthcare ...
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54 Pushing for More Payment Reform in Healthcare
https://sites.lsa.umich.edu/mje/2022/01/16/pushing-for-more-payment-reform-in-healthcare/
A new movement focused on reforming healthcare payment seeks to streamline costs to patients for service by isolating services provided by ...
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55 TEN BARRIERS TO HEALTHCARE PAYMENT REFORM AND ...
https://www.semanticscholar.org/paper/TEN-BARRIERS-TO-HEALTHCARE-PAYMENT-REFORM-AND-HOW-Miller/d061c32b2bb8d5464f500dc27b89aa8bf6854e11
He is a frequent speaker at national, state, and local programs on healthcare reform and has given invited testimony to Congress on payment reform.
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56 Tennessee Health Care Innovation Initiative
https://www.tnmed.org/tenncare-payment-reform/
The Tennessee Healthcare Innovation Initiative, otherwise known as TennCare payment reform, is the state's plan to reduce the cost of healthcare and ...
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57 Payment reform | Modern Healthcare
https://www.modernhealthcare.com/topic/payment-reform
Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.
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58 Paying for value over volume through payment reform
https://www.healthpolicyohio.org/wp-content/uploads/2016/04/Beyond_PaymentReform_FactSheet_Final.pdf
U.S. healthcare is built on a fee-for-service (FFS) system, which pays a provider for each specific service delivered to a patient. FFS often incentivizes.
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59 American College of Physicians Pushes Payment Reforms to ...
https://www.healthleadersmedia.com/clinical-care/american-college-physicians-pushes-payment-reforms-boost-value-and-equity
Policymakers and lawmakers have been seeking to replace fee-for-service reimbursement in healthcare with value-based payment models since ...
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60 CSC Towards Coordinated Care: Healthcare Payment Reform
https://www.dhs.state.il.us/OneNetLibrary/27897/documents/Mental%20Health/Pelletier/rLloyd/TowardsHealthCarePaymentReform.pdf
Introduction. Ideas and proposals for healthcare payment reform represent a significant departure from today's mix of flat fee, diagnosis-related group, ...
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61 The Health Care Payment Revolution
https://www.flmedical.org/florida/Florida_Public/Docs/Health-Care-Payment-Revolution-updated.pdf
The impetus for payment reform isn't a mystery. Policy makers, businesses and commercial payors are under tremendous pressure to control health care costs, ...
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62 Priorities in Focus–Care Affordability
https://www.ahrq.gov/workingforquality/reports/priorities-in-focus/care-affordability.html
Alternative payment models are formed to improve health and health care while lowering costs through payment and delivery reform, population health ...
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63 Payment Reform Archives - California Health Care Foundation
https://www.chcf.org/tag/payment-reform/
This issue brief outlines why these old payment rules are hurting patients during the COVID-19 crisis, and how transitioning to a new way of paying for care, ...
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64 Where's the Value? Six reasons why healthcare payment ...
https://sage-growth.com/index.php/2021/04/six-reasons-why-healthcare-payment-reform-has-stalled-and-what-the-future-might-hold-vbp/
The healthcare industry is notorious for moving slowly, and VBP is no exception. The ACA promised healthcare reform and delivered insurance ...
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65 Implications of healthcare payment reform for ... - APA PsycNET
https://psycnet.apa.org/record/2016-10609-001
Health reform, post the passing of the Patient Protection and Affordable Care Act, has highlighted the need to better address critical issues such as ...
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66 Emergency Medicine and Payment Reform
https://www.acep.org/administration/reimbursement/emergency-medicine-and-payment-reform/
Healthcare reform is introducing evolving methodologies for payment as opposed to the traditional fee for service model. Not all of the new payment ...
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67 CHQPR Calls for Delay in Medicare Value-Based Payment ...
https://michiganhpf.msu.edu/index.php/contact-us/2-uncategorised/29-chqpr-calls-for-delay-in-medicare-value-based-payment-modifier-and-urges-true-payment-reform
Center For Healthcare Quality & Reform Logo · CHQPR Calls for Delay in Medicare Value-Based Payment Modifier and Urges Rapid Implementation of True Physician ...
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68 Healthcare payment reforms across western countries on ...
https://www.sciencedirect.com/science/article/abs/pii/S016885101300078X
Healthcare payment reforms across western countries on three continents: Lessons from stakeholder preferences when asked to rate the supportiveness for ...
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69 Payment Reform Solutions | RTI Health Advance
https://healthcare.rti.org/solutions/payment-reform
With experts in health policy, economics, medical care, quality measures and risk adjustment, we'll optimize your approach to payment reform. See how.
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70 Catalyst for Payment Reform (CPR)
https://www.capc.org/collaborations/catalyst-payment-reform/
CAPC partners with Catalyst for Payment Reform (CPR) to educate and equip health care purchasers with resources needed to demand high-value health care for ...
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71 Our Past Work Reducing Health Care Disparities through ...
https://www.solvingdisparities.org/payment-reform/previous-work
Payment reform may be a potential solution, but reforms that do not explicitly consider disparities run the risk of unintentionally exacerbating or creating ...
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72 Value-Based Payment | HANYS
https://www.hanys.org/value_based_payment/
Healthcare reform at the federal and state levels is spurring the shift from volume to value, demanding providers to coordinate care across the healthcare ...
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73 Healthcare Payment Reform: From Principles to Action - HFMA
https://www.hfma.org/content/dam/hfma/document/comment_letter/PDF/5440.pdf
HFMA's Healthcare Payment Reform: From Principles to Action brings together the insights from a diverse group of system stakeholders and others to identify ...
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74 Envisioning a Better U.S. Health Care System for All
https://www.acpjournals.org/doi/10.7326/M19-2407
The fee-for-service (FFS) payment system bases reimbursement for physicians and other clinicians on the number of appointments, tests, or ...
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75 Randomized trial shows healthcare ... - Harvard University
https://scholar.harvard.edu/yunan/publications/spillover-effects-health-insurance-payments-evidence-randomized-controlled-trial
We estimate that the payment reform—which targeted traditional Medicare patients—had effects of similar magnitude on the healthcare experience ...
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76 AAFP Backgrounder - Physician Payment Reform
https://www.aafp.org/dam/AAFP/documents/advocacy/payment/BKG-PaymentReform.pdf
As a solution, health systems are moving toward offering blended payment models with FFS and value-based payments that reward clinicians on quality of care and ...
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77 The Next Frontier For Value-Based Payment Reform
https://healthbegins.org/october-2021-equity-place-the-next-frontier-for-value-based-payment-reform/
evidence that this model can help solve some of the cost and quality problems rife in the U.S. healthcare system, challenges remain— ...
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78 The Impact of Provider Reimbursement on Overall Cost of ...
https://axenehp.com/paying-healthcare-providers-impact-provider-reimbursement-overall-cost-care-treatment-decisions/
Bundled payments, also known as episode-based payments, are the reimbursement of health care providers on the basis of expected costs for ...
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79 Understanding the Public Policy of Global Budget Payment ...
https://www.frontiersin.org/articles/10.3389/fpsyg.2022.911197/full
Based on this background, the reform of healthcare insurance payment method (HIPM) has become one of the core contents of healthcare insurance ...
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80 Strengthening Primary Care Delivery through Payment Reform
https://nap.nationalacademies.org/resource/25983/Strengthening%20Primary%20Care%20Delivery%20Through%20Payment%20Reform.pdf
This paper strongly takes issue with the payment continuum concept reflected in explicit HHS and Centers for Medicare & Medicaid Services (CMS) policy (Health ...
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81 Safety Net Representation in Federal Payment and Care ...
https://www.ajmc.com/view/safety-net-representation-in-federal-payment-and-care-delivery-reform-initiatives
Payment reform can provide safety net organizations with the opportunity to improve the health of the nation's most vulnerable populations, but ...
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82 The impact of provider payment reforms and associated care ...
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0214382
Multiple policy reforms have been launched in cancer care, but provider payment models remain an area of contention among policy makers.
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83 Payment Reform: Analysis of Models and Performance ...
https://www.rand.org/content/dam/rand/pubs/technical_reports/2011/RAND_TR841.pdf
a cornerstone of health care payment reform. With the support of the National Quality Forum. (NQF), the RAND Corporation conducted this evaluation, ...
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84 Oncology Payment Reform to Achieve Real Health Care Reform
https://ascopubs.org/doi/full/10.1200/jop.2015.004655
Accountable care payment reforms require meaningful cost and quality measures to help assure that the payment changes and care reforms they ...
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85 How to reform western care payment systems according to ...
https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-0847-7
Many developed countries are reforming healthcare payment systems in order to limit costs and improve clinical outcomes.
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86 The Need to Understand Healthcare Payment Reform
https://consultqd.clevelandclinic.org/need-understand-healthcare-payment-reform/
Hospital value-based purchasing is part of the Centers for Medicare and Medicaid Services' long-standing effort to link the Medicare payment ...
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87 Moving the needle on payment reform - assets.kpmg
https://assets.kpmg/content/dam/kpmg/xx/pdf/2017/09/moving-the-needle-on-payment-reform.pdf
As a result, changing reimbursement incentives to align with desired outcomes through payment reforms will alter both the cost trajectory for healthcare ...
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88 Design value-based models with equity in mind, experts say
https://www.fiercehealthcare.com/payers/reforming-health-insurance-payment-reform
Most healthcare experts agree that something needs to be done to reform payment systems, note the authors, but effective reform must “reconcile existing ...
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89 4 Payment and Organizational Reforms to Improve Value
https://www.nap.edu/read/18393/chapter/6
Pay-for-performance and VBP have been touted as effective interventions for improving health care outcomes, yet evaluation results are mixed. Although a large- ...
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90 Driving Value in Healthcare – Alternative Payment Models
https://www.ldi.la.gov/docs/default-source/documents/ldi-convention/2020-presentations/dr-daniel-marsh---value-based-health-care.pdf?sfvrsn=ed004f52_6
for healthcare payment reform. FFS has never been able to control costs, no matter what has been tried. FFS motivates provider to increase and not.
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91 ALIGNING FEDERAL AND STATE EFFoRTs oN PAyMENT ...
http://www.statecoverage.org/files/NASHP_Aligning_Federal_State_Payment_Reform.pdf
Aligning Federal and State Efforts on Payment Reform. National Academy for State Health Policy. TAbLE oF CoNTENTs. Acknowledgements. 1. Executive Summary.
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92 Implications of Healthcare Payment Reform for ... - Springer
https://link.springer.com/article/10.1007/s10880-016-9451-1
The vast majority of healthcare delivery in the US is paid for through a mechanism called fee-for-service (FFS; Miller, 2015b). FFS payments ...
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