Value-Based Payment Models Options-by-State
| Editor’s Note: BHM provides data reporting tools, metrics, and services integral to overcoming barriers to value-based payment models. By reviewing cases for utilization, medical necessity criteria, and process metrics, BHM determines shortfalls, especially on the most complex care like behavioral health. Click HERE and discuss how BHM services reach your goals. |
New study finds over 40 states pursuing value-based payment models, with 15 multi-payer initiatives across those states. The study reveals a range of approaches and significant variation in the scope, leadership commitment, and resources devoted to the transition from fee-for-service to value-based reimbursement.
Change Healthcare has conducted a review of the 50 states’, plus Puerto Rico’s and Washington DC’s, payment reform initiatives. The study reveals a range of approaches and significant variation in the scope, leadership commitment, and resources devoted to the transition from fee-for-service to value-based reimbursement.
Download the INFOGRAPHIC below for an aggregated look at which strategies states have adopted, whether they have chosen to set VBP targets, the scope of their initiative (Medicaid or multi-payer), and the approximate year that the VBP initiative was implemented.
Click to Download Infographic: 50-State Matrix
“This report clearly shows that most of the country is committed to value-based payment as a key component of health reform in order to bend the cost curve and ultimately achieve the Triple Aim,”
Carolyn Wukitch,
Senior Vice President & General Manager,
Network and Financial Management,
Change Healthcare
23 states have value-based targets or mandates that payers and providers agreed to achieve, 17 have or are considering adoption of ACOs or ACO-like entities, and 12 have or are considering episodes of care programs. Just 7 states have little to no activity around value-based payment models.
BHM provides data reporting tools, metrics, and services integral to overcoming barriers to value-based payment models. By reviewing cases for utilization, medical necessity criteria, and process metrics, BHM determines shortfalls, especially on the most complex care like behavioral health. Click HERE and discuss how BHM services reach your goals.
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