Implementing Physician Payment Reform: Lessons from Community Health Plans

Report release on ACHP members' implementation of alternatives to the fee-for-service payment system

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Overview

Please join us on September 17 at 3:00 pm EDT for the release of Implementing Physician Payment Reform: Lessons from Community Health Plans, ACHP’s new report on member organizations’ successful alternatives to fee-for-service payment models. ACHP members are community-based plans that are national leaders in health care quality, and annually rank among the top-performing health plans in the nation.

The report highlights payment reforms currently in place at seven ACHP member organizations:

·         Capital District Physicians’ Health Plan (Albany, New York)

·         Geisinger Health Plan (Danville, Pennsylvania)

·         HealthPartners (Minneapolis, Minnesota)

·         Independent Health (Buffalo, New York)

·         Priority Health (Grand Rapids, Michigan)

·         Tufts Health Plan (Watertown, Massachusetts)

·         UPMC Health Plan (Pittsburgh, Pennsylvania)

The publication and presentation will focus on the key elements ACHP has deemed essential for successful payment reform:

·         A strong infrastructure to support physician transformation, along with a culture of information transparency.

·         Phased transition away from fee-for-service, beginning with primary care.

The report release webinar will feature three ACHP medical directors: Dr. Ray Roth, vice president and chief medical officer of Geisinger Health Plan; Dr. Pat Courneya, medical director of HealthPartners; and Dr. Paul Kasuba, senior vice president and chief medical officer of Tufts Health Plan.

During the meeting, the medical directors will discuss the metrics, measurements and processes that have allowed them to create a clear system of transparency in their organizations with relation to quality, use, cost and patient data. They will discuss the details of their work to develop metrics that are meaningful to patients and physicians, and how performance against those metrics is incorporated into physician payment.

As the primary care physician should be at the center of a system that is responsible for the health of a defined total population, ACHP member organizations have begun their initial payment transformation with primary care. The report concentrates on a variety of payment reform approaches from ACHP member organizations, and the medical directors will discuss the specifics of their organization’s approach during the webinar. 

This event will serve as a unique opportunity to hear policy and best practice recommendations for physician payment reform from a number of leading ACHP health plans.

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