Health care payment in transition: a California perspective
- Collection:
- Health Policy and Services Research
- Contributor(s):
- Oberlin, Shelley. Tackett, Scott. Macdonald, Philip. Stanton, Stacey. California HealthCare Foundation.
- Publication:
- Oakland, Calif. : California HealthCare Foundation, c2012
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Delivery of Health Care -- economics Delivery of Health Care -- trends Diffusion of Innovation Health Care Reform -- economics Models, Econometric Cost Control -- economics Cost Control -- trends Economics, Medical -- trends Efficiency, Organizational Forecasting History, 20th Century Outcome Assessment (Health Care) -- economics Quality Improvement -- economics Quality Improvement -- trends Reimbursement, Incentive -- economics Reimbursement, Incentive -- trends Humans California United States
- Genre(s):
- Technical Report
- Abstract:
- The United States spends more per capita and a higher percentage of its gross domestic product (GDP) on health care than any other country. Yet other developed countries outperform the US on measures of quality, efficiency, and access. Many believe that the entrenched quality and cost challenges of the US health care system are largely due to how health care services are paid. In the US, current payment models do not provide incentives that regard value (improved quality and services at a lower cost); instead, they provide incentives for high volumes, often leading to overutilization of services and high costs. To actualize a health care system that not only decreases spending, but better aligns costs with outcomes, there is an urgent need for payment reform. As California has historically introduced innovative payment models that promote greater efficiency and lower costs, many are interested in how the California market will respond and transition to emerging payment approaches. This report presents 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. Interviews were conducted and multiple meetings held with an Advisory Group comprised of known health care leaders in California and other areas of the country. Using information gathered from these interviews and meetings, this report: (1) provides an overview of and historical context for the current payment landscape in California, (2) highlights new payment models under consideration of that appear to be the most likely to advance in California (and perhaps nationwide) over the coming years, (3) discusses dominant themes regarding California's evolution towards future payment models, and (4) discusses implications and strategies key stakeholders (providers, patients, purchasers, and policymakers) should consider during a new payment methods transition period. This report is meant to be a primer on payment models in California, providing basic information for a wide set of interested parties across the care continuum ranging from board members to administrators to policymakers.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101604071 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101604071