©aahcm. no conflicts ©aahcm privileged and confidential: prepared in accordance with new york...
TRANSCRIPT
©AAHCM
HEALTH SYSTEM PERSPECTIVES
©AAHCM
No Conflicts
©AAHCM
©AAHCM
The Era of Commercial Insurance Increases Making Up for Medicare and Medicaid Losses is Ending
Privileged and Confidential: Prepared in accordance with New York State Public Health Law 2805 j through m; New York State Education Law 6527; & Federal Law 109-4.
©AAHCM
Fee For Service Rates Will Not Keep Up With Expenses
Privileged and Confidential: Prepared in accordance with New York State Public Health Law 2805 j through m; New York State Education Law 6527; & Federal Law 109-4.
©AAHCM
FEE-FOR-SERVICE PAYMENT FOR VALUE
ELIMINATE WASTE
IMPROVE QUALITY
MANAGE POPULATIONS
FROM TO
ComponentsIntegrated Delivery Systems
Clinically Integrated Networks
Care Management Systems
Novel Provider Payer Relationships
Centers of Excellence
9
PAY FOR PERFORMANCE
BUNDLED PAYMENTS
SHARED SAVINGS
PARTIAL RISK
FULL RISK
PENALTY AVOIDANCE
10
TRANSITIONAL CARE
COMMUNITY BASED EPISODIC CARE
COMMUNITY BASED PRIMARY CARE
SPECIALIZED CONDITIONS
GENERAL POPULATIONS
11
HOUSE CALLS
HOME CARE PROVIDERS
HOME BASED PRIMARY CARE
HOUSE CALL DOCTORS
HOME CARE PHYSICIANS
REDUCING READMISSIONS
MAINTAINING PATIENTS IN THE LOWEST COST SETTING
MOVING PALLIATIVE CARE UPSTREAM
MITIGATING OVERTREATMENT
MANAGING THE COSTLIEST MEMBERS
FROM TO
QUESTIONS