Assessing and Accelerating State Implementation of Value-Based Payment Reforms

While most of what we know about alternative payment models and value-based reforms comes from the experience of Medicare and commercial payers, state Medicaid programs and other state programs (like state employee health plans) are also implementing new models and programs. The session will review the current evidence on a variety of state value initiatives. First, the session will explore the identification of a state’s most important and actionable improvement opportunities using data and tools, including service utilization and price variation. Second, it will examine how states implement various payment and delivery reforms, such as multipayer bundles, all-payer ACO models, advanced medical homes, or integrated behavioral health. Third, it will look at promising state initiatives aimed at prescription drug costs, such as subscription models for drug purchasing or efforts to increase state purchasing power. Finally, the session will consider new models that address social determinants of health in Medicaid populations through waivers, accountable health communities, or integrating social services and non-medical interventions. This session will also focus on the resources necessary for success, including data sharing for provider feedback, clinical care management to help practices succeed under new payment models, and will explore other critical implementation challenges states face in standing up such programs.