Health Care Payment in Transition: A California Perspective
January 9, 2012
Health care payment systems in California are in transition, pressed by market and economic factors as well as health reform mandates. New payment approaches are emerging while traditional ones still exist. During this transitional period, health care stakeholders including providers, public and private payers, purchasers, and policymakers will be making decisions about the future of payment systems in the state.
This report provides information about the historical context of payment systems in California and the current landscape. It discusses seven common payment models and nine emerging models that have already been implemented, are undergoing experimentation, or are likely to advance in the state. Insights about the evolution of the payment system under health reform include the following:
The transition to future payment models will be evolutionary, not revolutionary.
There is no one-size-fits-all approach.
Large employers and purchasers of health care are likely to have a dominant role in driving payment reform.
Finally, the report discusses considerations and strategies that stakeholders should take into account as they transition to future payment models. These include:
Service line consolidation
Robust analytics around a common patient identifier
Incentives that align value and effectiveness
Impact of the cost of doing business
The complete report is available under Document Downloads.