Scenario

After years of working within a healthcare system, you have transitioned into a role with the largest private payer in your state. Your organization has recently taken an interest in transitioning from a straight-forward fee-for-service reimbursement model to one that focuses on outcomes, incentivizing providers for reducing unnecessary cost and improving patient experience. Since you have experience working with providers, the CFO has volunteered you to do some research to kick-off the first workgroup meeting!

The task requires you to review studies that could help the team understand the impact this transition could have, the different options that could be considered, and the importance of utilizing appropriate statistics throughout the process. In your research, you came across a report in the Milbank Quarterly titled States Encouraging Value-Based Payment: Lessons From CMSàState Innovation Models Initiative. It has given you a lot of great information to use in your proposal.

Instructions

You will need to develop a proposal that:

Summarizes the study ôates Encouraging Value-Based Payment: Lessons From CMSàState Innovation Models Initiative)ncluding the intent, participants, and data collection methods used.

Compares different types of value-based care models used by participating states, including patient centered medical home, accountable care organizations, and episodes of care.

Recommends one model as the initial next step.

Describes the importance of health IT and data, including the key statistics that must be documented and monitored specifically to your selected model.

• Addresses some of the challenges faced by the participating states regarding health IT and data.
• Explains how the statistics reported within this study can be applied to your organizationàstrategic plan to transition away from a straight-forward fee-for-service reimbursement model.
• Uses professional language and tone with correct spelling, grammar, and punctuation in the policy and procedure documents.