A key component of the national health care reform legislation entails testing various integrated care models (such as medical homes and accountable care organizations) and new payment mechanisms to improve patient quality and safety while cutting costs.
Some of these payment mechanisms enable systems of providers (for example, hospitals and primary care and specialty) to share with government and private insurers the savings they generate if they meet certain quality and cost reduction targets. Other mechanisms are designed to provide a “per patient per month” payment to physician practices, such as Patient-Centered Medical Homes, to manage and coordinate care for a particular patient population.
The Health Council is convening members’ participation in an intensive exploratory process aimed at developing a regional strategy in support of payment reform.
Working with the Brookings Institution and area hospital/health system leaders, with preliminary input from health plan executives, a white paper, or “roadmap,” has been developed that is guiding discussions with various stakeholders in Greater Cincinnati.
The Council and a group of area hospital/health system leaders joined with health plans, businesses and safety net organizations at a symposium in 2011 to begin to develop a regional strategy to prepare for federal payment reform and explore the readiness and willingness of Greater Cincinnati to apply for federal payment initiatives.
Symposium participants reached agreement on critical next steps, including supporting the health plans and Ohio Medicaid to apply for the CMS Innovation Center’s Comprehensive Primary Care Initiative. It was announced in April 2012 that the Cincinnati/Dayton region has been selected for this new multi-payer approach that could dramatically change the way primary care is delivered and financed in this region.