This is an excellent summary of the various payment methods that are being considered by Massachusetts.With their health reform plan costing much more than they expected they have a burning platform.
This summary describes why the state has decided to focus on "global payments" rather than "episode payments". Global payments, the authors argue, are focused on appropriateness of care in addition to quality and cost. Episodes of care payment systems assume what is being done medically is appropriate and necessary. How do we know whether treatment is appropriate and necessary? This paper suggests that total cost of care payment is the best way get providers to focus on appropriateness. Of course, there is no perfect answer here as our experience with global payments otherwise known as capitation in the '90s taught us.The authors also argue global payments are the best method to support the concept of a medical home because the global payments can be redistributed more easily to support the expertise needed to better manage the entire condition.
There is an excellent executive summary which I would suggest reading first.
MassPaymentReformComm.d
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