Good article for certified case managers and those interested in alternative payment methods and how they shape healthcare IT
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The article, “How these three alternate payment models are driving healthcare IT”, by By Paddy Padmanabhan, states
“To pursue the Triple Aim – improve the patient experience of care, improve the health of populations, and reduce the per capita cost of health care – the Department of Health and Human Services (HHS) has set a goal of tying 50% of Medicare fee-for-service payments to value through alternative payment models (APM) by 2018.
APMs seek to deliver better care at lower cost. APMs require providers, payers, and others in the healthcare system to make fundamental changes in their day-to-day operations that would improve quality and reduce the cost of healthcare. Through APMs, the HHS is pushing the healthcare sector toward a population health management (PHM) model.
As of late 2016, an estimated 25% of commercial healthcare dollars flowed through alternate payment models associated with PHM initiatives. This trend is an indicator of the progress of APMs in incentivizing healthcare providers to change their economic preferences on risk-based payment models.
Understanding APM’s is important as they drive behavior that impacts business models of healthcare enterprises and technology solution providers alike. Before exploring APMs, it is useful to understand the dominant payment model today – fee-for-service. ”
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