Since the early days, Catalyst for Payment Reform (CPR) made it part of our mission to spur and track the growth of payment reform. And boy have we seen it take off! To whom do we owe the progress? Payers, purchasers, and states have each played a role in driving reform efforts and providers have become more eager too. The growth seems most prominent through shared savings arrangements—most often associated with accountable care organizations (ACOs). This is occurring across geographies and payers throughout the U.S.
At the same time, we know that there is no one size-fits-all solution for improving quality, efficiency and affordability in health care. We encourage all players to remember that payment reform should be tailored to local market dynamics. What works in one market might fail miserably in another. So before jumping on the ACO bandwagon, state-based organizations should consider the following:
- The influence and experience of the health care stakeholders in a specific market can affect reform implementation. Providers and payers must be open to, have experience with, and have the infrastructure in place to implement value-based strategies.
- The state legal and regulatory environment can also dictate reform implementation. State laws and regulations can prevent or support the implementation of certain health care reforms. For example, network adequacy laws prohibit the formation of narrow networks. Other laws require states to provide a website with provider price and quality information.
- Once a state chooses an appropriate market-based reform, think about how to measure the impact. With CPR’s new version of the Scorecard, we can begin to track how the prevalence of payment reform—and certain reforms in particular—correlates with delivery system changes, patient outcomes, and affordability, among other aspects.
Luckily, CPR has resources to help you assess local market dynamics, the state legal and regulatory environment, the growth of payment reforms and the impending impact! We are here to help you in your process for selecting a new payment method. Contact Us to learn more.