3 ways grantmakers can promote payment reform

In a time of major shakeups for how healthcare providers receive payment, there are several steps funders can take to promote meaningful payment reforms, according to a Health Affairs blog post.

In the wake of the U.S. Department of Health and Human Services' announcement of Medicare payment reforms, grantmaking organizations must explore opportunities for promoting alternative payment models, write Michael Bailit, founder of Bailit Health Purchasing, LLC, and Andrea Ducas of the Robert Wood Johnson Foundation. Here are a few of their suggestions:

Promote the development and testing of models that align public health, social service and behavioral health incentives: The Center for Medicare and Medicaid Innovation devotes special attention to strategies that better integrate services that address social factors in health, as well as those that align healthcare delivery and public health programs, Bailit and Ducas write. Alignment of population-based healthcare approaches is still largely theoretical, however, the authors say.

Analyze obstacles to safety-net provider participation in payment reform and potential solutions to those barriers: Alternative payment models have yet to catch on among safety-net providers, the post states, largely because they often lack the capital to invest in new resources. For this reason, the authors suggest that foundations step in to support researchers and provide assistance to healthcare providers based upon their specific needs.

Promote alternative payment models that address unmet needs: Many payment reform opportunities have not been explored, the authors write, and grantmakers have an opportunity to step in on some of these, such as ideas for aligning incentives for price-sensitive consumers. Specialty pharmaceuticals are another, similarly untapped model, particularly given the large proportion of pharmacy spending devoted to specialty pharmaceuticals.

"Grantmakers … have played an important role in developing and spreading payment reform," the authors write. "With its application now achieving wide acceptance and growing quickly, funders should consider what the future of payment reform might look like and what steps they could take--individually and in collaboration--to address unmet challenges and ensure future success."

To learn more:
- here's the blog post

 

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