Healthcare Reform Stakeholders Summit, Fall 2015 - Episode 10

Innovative Payment and Delivery Models: Are They Working?

There are a lot of new payment and delivery models available and being tested, but the US still doesn’t have a payment system that aligns people’s incentives the right way, said Margaret E. O’Kane. Instead, with fee-for-service around, people still have an incentive for overuse, because they can make money.

Watching the new payment and delivery models, though, she pointed out that it’s important to not just get caught up on whether a certain model work. That’s not the right mindset. Instead, people should choose a model and make it work by adjusting it until payment policies are in place to reward efficiency.

Matt Salo added that while it’s great to consider shared savings or bundled payments, they need to be paired with the right tools to make them work. He used the example that primary care physicians need to be shown how to set up a patient-centered medical home, how to structure it, who to hire, etc.

He tied the conversation into patient engagement in new delivery models and figuring out what motivates the patient and why, for instance, are families overusing the emergency room.

“You’ve got to figure out why are they doing what they’re doing that’s wrong, and how do you empower them to do the right thing,” Salo said.