Redesigning health care delivery, and changing the way we pay for health care services, must progress hand in hand. Ultimately, people and the systems within which they work respond to incentives – so changing monetary incentives is the critical first step to changing the health care delivery system.
Colorado's path toward achieving financial incentives that are aligned with quality and outcomes is described in CIVHC's “Framework for Transforming the Health Care Payment System in Colorado.” The Framework is the product of a day-long facilitated retreat in January 2011 where nearly 60 participants from 49 organizations – representing providers, purchaser, payers and patients – brainstormed the principles and approaches that undergird the Framework and its ambitious goals.
CIVHC Payment Reform Goals
| By 2015 (Midway Milepost) |
By 2018 |
| Severity-adjusted bundled payments for specified chronic conditions and treatment episodes |
Most care provided in coordinated (real and virtual) health care delivery systems, paid through global capitation with some fee-for-service |
| Care management payments to primary care practices for care outside bundled arrangements; some fee-for-service payments still |
Patients full, equal partners in their care |
| Fee-for-service payments to specialists for care outside bundled arrangements |
Public health a full partner |
To support reaching the 2018 goals, CIVHC engages with payment reform initiatives in Colorado and nationally by acting as a convener, facilitator and connector. CIVHC has supported Colorado participation in several Center for Medicare & Medicaid Innovation Center programs including the Health Care Innovations Challenge and the Comprehensive Primary Care Initiative.
Payment Reform Operations/Implementation Workgroup
Members of our previous Payment Reform and Consumer Engagement groups, as well as stakeholders from across the spectrum, are responsible for fleshing out and implementing the Midway Milepost. Click here to learn more.
CIVHC Payment Reform Resources
Colorado Payment Reform Presentations
National Payment Reform Resources
Please contact Edie Sonn, VP of Strategic Initiatives, for more information.