Alternative Payment Models

Question 1

define value

Answer 1

health outcomes achieved per dollar spent

Question 2

role of CMMI

Answer 2

-fee for service payment models bc rewards volume, not value

Question 3

medical homes

Answer 3

-team based models of patient care
-rely heavily on PCP/team
-focus on coordination of majority of health, illness, wellness care for medicare

Question 4

ACO

Answer 4

-providers group together and agree to share collective accountability for the quality and cost of care
-payments to ACOs incorporate financial incentives in the form of shared savings or losses for performance on deintifeid spending and quality metrics
-incentivisted to order more, do more to increase payment

Question 5

bundled payments

Answer 5

-focus on discrete episodes of care
-overall budget for services provided to patient receiving course of tx for a given clinical condition over defined period of time
-provide incentives to providers to come in under budget

Question 6

bundled payment types of incentives

Answer 6

-mandates
-non financial incentives
-financial incentives

Question 7

what are the elements of the triple aim

Answer 7

1. improved health
2. cost containment
3. improved healthcare

Question 8

what is the best for a medical home payment reform model

Answer 8

chronic disease managemetn