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From Volume- to Value-Based Payment System in Washington State Federally Qualified Health Centers: Innovation for
Aniyar Izguttinov1, Douglas Conrad, Suzanne J Wood
1Evidence Based Practice Institute, Department of Psychiatry and Behavioral Sciences, UW Medicine, University of Washington, Seattle (Mr Izguttinov); and Department of Health Services, School of Public Health, University of Washington, Seattle (Mr Izguttinov, Drs Conrad and Wood, and Ms Andris).
Abstract:
The reimbursement system at 16 Federally Qualified Health Centers in Washington State transformed to a per-member-per-month model with a prospective adjustment for quality performance. The results of this qualitative study suggest that 3 to 5 years would be required to achieve significant progress in the Triple Aim goals of the initiative and also demonstrate that Federally Qualified Health Centers are potentially more advanced in their readiness to offer value-based care. By providing positive financial incentives without downside risk, the state is stimulating replicable models of care, and in longer term such reforms may lead to a greater care coordination and a whole person-centered care.
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