Anyone have thoughts / opinions on the public option in Vermont?
How might it affect anesthesiology / pain groups ?
How about other medical specialties?
Links below:
"We have seen that changes in health care payment can drive more fundamental change. Since 2006, Vermont has been pursuing an ambitious project aimed at implementing the advanced primary care medical home model for care delivery. The states Blueprint for Health augments the capacity of physician practices with a community health team that helps manage patients care and connects them with social services. It also provides bonus payments, through all payers, whose amount is linked to performance on quality metrics. In January, the project will expand to include anchor specialists attached to advanced primary care medical homes, with bonus payments linked to both quality and total cost of care.
The next phase of our payment reforms will build on the Blueprints foundation of pay for performance and also move some groups of providers into budgeted or virtually budgeted arrangements. Such groups could include those capable of accepting a single, global payment for the complete care needs of a population, as well as looser affiliations of providers who will receive fee-for-service payments but face some combination of risk and reward if their total payments end up being above or below a targeted per capita level. The board will explore various models, as well as the use of bundled payments by all payers. The key to the boards success will be focusing on implementing a narrow array of reforms that are predicted to have a high likelihood of success. The reforms must be readily understood by providers and create clear and strong incentives for re-engineering delivery systems and care patterns and making more efficient use of capital, technology, and human resources.
Our biggest challenge will be making the transition to a budgeted world. Much of Vermonts existing regulation has been aimed at ensuring financial solvency for institutions, both hospitals and insurers. New payment models aimed at reducing waste and improving prevention and chronic care management necessarily shift resources out of the hospital. The Blueprint for Health already confirms this effect: as we have invested in and rewarded good primary care, hospital admissions and readmissions have been reduced. How do we continue this trend but assure Vermonters that they will have appropriate access to specialty and hospital services within their communities?"
Original article in NEJM
http://healthpolicyandreform.nejm.org/?p=14965&query=home
How might it affect anesthesiology / pain groups ?
How about other medical specialties?
Links below:
"We have seen that changes in health care payment can drive more fundamental change. Since 2006, Vermont has been pursuing an ambitious project aimed at implementing the advanced primary care medical home model for care delivery. The states Blueprint for Health augments the capacity of physician practices with a community health team that helps manage patients care and connects them with social services. It also provides bonus payments, through all payers, whose amount is linked to performance on quality metrics. In January, the project will expand to include anchor specialists attached to advanced primary care medical homes, with bonus payments linked to both quality and total cost of care.
The next phase of our payment reforms will build on the Blueprints foundation of pay for performance and also move some groups of providers into budgeted or virtually budgeted arrangements. Such groups could include those capable of accepting a single, global payment for the complete care needs of a population, as well as looser affiliations of providers who will receive fee-for-service payments but face some combination of risk and reward if their total payments end up being above or below a targeted per capita level. The board will explore various models, as well as the use of bundled payments by all payers. The key to the boards success will be focusing on implementing a narrow array of reforms that are predicted to have a high likelihood of success. The reforms must be readily understood by providers and create clear and strong incentives for re-engineering delivery systems and care patterns and making more efficient use of capital, technology, and human resources.
Our biggest challenge will be making the transition to a budgeted world. Much of Vermonts existing regulation has been aimed at ensuring financial solvency for institutions, both hospitals and insurers. New payment models aimed at reducing waste and improving prevention and chronic care management necessarily shift resources out of the hospital. The Blueprint for Health already confirms this effect: as we have invested in and rewarded good primary care, hospital admissions and readmissions have been reduced. How do we continue this trend but assure Vermonters that they will have appropriate access to specialty and hospital services within their communities?"
Original article in NEJM
http://healthpolicyandreform.nejm.org/?p=14965&query=home
