Towards Coordinated Care: Healthcare Payment Reform

Author:

Tom Enders, Jason Fortin, Melissa Harmon

Ideas and proposals for healthcare payment reform represent a significant departure from today’s mix of flat fee, diagnosis-related group, per diem, and percent of fee-schedule reimbursement toward a system that ties payments to high-quality, tightly coordinated care.  In the near term we expect experimentation with approaches that couple fee-for-service with new models of payment linked to results, and in the long term a generational shift to a new structure for reimbursement.

In this paper, we outline the four underlying concepts behind payment reform proposals and discuss how provider organizations can prepare for these new models.

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