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Resource Overview
  • Rationale
  • Challenges
  • Approach

Everyone is talking about paying for value instead of volume in health care, and payers and providers are currently testing and using many new payment models aimed at achieving the Triple Aim of better patient care, better population health, and lower costs.

Even as payers continue to refine the definitions and related frameworks of value based payment, we define value based payment simply as a systematic method of paying for care that rewards the cost-effective improvement of the health and well-being of a population. This method incorporates the social, behavioral and economic factors that influence health.

Thriving in a value based payment world requires data-driven approaches to quality improvement and financial sustainability. Multi-sector collaboration using health information exchange, population health management, and patient engagement, each using digital strategies play a critical role in the success of Health Centers in this new reality. This resource set aims to support the data-driven success in value based payment models among Health Centers.

Under value based care, health care providers and non-clinical collaborators are assuming responsibility, and often financial risk, for both health outcomes and costs of defined populations. Health Centers need tools to:

  • Understand current value based payment strategies and their implications
  • Engage with payers and partners by communicating their value proposition using robust data from both Health Centers and the broader health care system
  • Use both internal and external data sources to succeed under new financial risk contracts and to support collaborations in sustainable pursuit of the Triple Aim
  • Glean lessons learned regarding health information technology infrastructure from other Health Centers and communities pursuing value based payment strategies.

This section is organized based on the stages of engaging in value based payment with the idea that, nationally, Health Centers and their policy/payment environments are on a diverse continuum of pursuing these new payment models. This resource set follows that continuum. Health Centers that are relatively new to value based payment require a strong foundation and vocabulary for discussing strategies with their boards, staff, payers, and policy-makers. Health Centers also require an understanding of how they are affected by various payment models—particularly with regard to investments in health information technology.

Once Health Centers understand the basics, they need to engage payers and partners in conversations regarding collaboration and strategies. To do this, Health Centers often need to make a value proposition to these key collaborators.

Finally, as Health Centers nationwide increasingly pursue and participate in value based payment models, they need robust, data-driven tools to understand the potential impact of these payment methods. In addition, Health Centers need to learn from each other on how to overcome obstacles and innovate care.

Addressing these areas will be key to Health Centers’ success in these new models, which leverage Health Centers’ deep expertise in pursuing the Triple Aim.

Acknowledgements

This resource collection was cultivated and developed by the HITEQ team with valuable contributions from the HITEQ's Advisory Committee and many health centers who have graciously shared their experiences with HITEQ.

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The Quadruple Aim
Quadruple Aim

A Conceptual Framework

Improving the U.S. health care system requires four aims: improving the experience of care, improving the health of populations, reducing per capita costs and improving care team well-being. HITEQ Center resources seek to provide content and direction aligned with the goals of the Quadruple Aim

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