Partners
MAKING A DIFFERENCE

Maine Health Management Coalition Foundation

A Value-Based Payment Model: Creating Incentives for Coordinating Patient-Centered Care

Challenge

The current health care payment system fuels higher health care spending since it rewards those who provide more services as opposed to those who provide high quality care. Different approaches to payment could improve quality and patient outcomes at lower costs.

Solution

Businesses and government entities seek new ways to pay for care that provide incentives for delivering the right care at the right time, with decision-making shared between the patient and provider to reduce costs and improve quality.

Impact

The pilot projects will better align payment and quality, resulting in:

  • Reduced overall cost of care
  • Better quality of care by reducing inappropriate interventions, paying for care that experts recommend, and increasing patient involvement in decision-making
  • Identification of successful Maine models for re-designed delivery of care

Maine Health Management Coalition Foundation will support pilot models of health care delivery reorganization and payment redesign.These models include features such as:

  • Global payments to providers that cover all care for a group of patients including primary care, outpatient services and hospitalizations for major acute illnesses (Accountable Care Organization model)
  • Consumer incentives to promote healthy behaviors, use of preventive care services, and completing care plans for chronic conditions (Value Based Insurance Design)