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Related Experiment Videos

States Encouraging Value-Based Payment: Lessons From CMS's State Innovation Models Initiative.

Stephanie M Kissam1, Heather Beil1, Christina Cousart2

  • 1RTI International.

The Milbank Quarterly
|April 9, 2019
PubMed
Summary

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State policies and targeted investments drove value-based payment (VBP) models and improved care coordination. State governments can effectively shape healthcare policy through regulatory levers and strategic investments in health IT and provider support.

Area of Science:

  • Health Policy
  • Healthcare Innovation
  • Value-Based Care Models

Background:

  • Six states received federal funding through the State Innovation Models (SIM) Initiative to transition from fee-for-service to value-based payment (VBP) models.
  • The initiative aimed to transform healthcare systems by leveraging state government policy and purchasing levers.

Purpose of the Study:

  • To analyze how state governments implemented VBP models and influenced healthcare delivery changes.
  • To identify factors contributing to multipayer alignment and enhanced care coordination.

Main Methods:

  • Qualitative data analysis of state SIM Initiative implementation from 2014-2018.
  • Inclusion of interviews, focus groups, and document reviews.

Main Results:

Keywords:
MedicaidState Innovation Models Initiativecare coordinationhealth care reformhealth information technologyperformance-based payment modelsstate governmentteam-based carevalue-based payment

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  • State policies and Medicaid VBP models were key to implementation.
  • Multipayer alignment was more feasible in states with fewer commercial payers or stronger state mandates.
  • Investments in health information technology and provider support facilitated care coordination improvements.

Conclusions:

  • State governments possess significant power to shape healthcare policy and drive multipayer alignment in VBP models.
  • Targeted investments in infrastructure and support are crucial for delivery system transformation beyond VBP adoption.