Payment & Financing - California Health Care Foundation

Payment & Financing
US health care spending is still too often based on the amount of services provided to a patient rather than the value of those services in improving a patient's health. This encourages more — not better — health care and increases costs. CHCF is helping to move health care payment and financing in California to a value-based system that supports the Triple Aim of improved population health and patient experience as well as lower costs.

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Modernizing Payment to California’s Community Health Centers

Health centers are crucial to California's response to COVID-19. But the care they provide is still dictated by old payment rules that severely hamper health centers' ability to care for patients during COVID-19 and, in some cases, keep their doors open. This collection focuses on how California can change the way it pays health centers to better serve patients and to create a more resilient foundation for primary care in Medi-Cal.

Why a Shared Savings Program Is Critical to CalAIM

January 28, 2020

Anne Sunderland

Medi-Cal, Payment & Financing

Chris Perrone, CHCF’s director of Improving Access, explores California's rare opportunity to chart a new course for Medi-Cal for years to come.

Shared Savings: Financial Incentives to Spur Better Care for Medi-Cal Patients

Medi-Cal, Payment & Financing

The Department of Health Care Services's CalAIM process would change the way it pays Medi-Cal managed care plans to incentivize long-term improvements in quality of care and health outcomes for patients. It specifically calls out the need and potential benefit of a shared savings program, which would be an important, and overdue, advancement.

2019 Edition — Health Care Costs 101

Katherine Wilson

Health Care Costs, Payment & Financing

National health spending grew by 3.9% in 2017, slower than the 4.8% growth in 2016. This Almanac report, Health Care Costs 101: Spending Keeps Growing, details how much is spent on health care in the US, which services are purchased, and who pays.

2018 Edition — Health Care Costs 101

Katherine Wilson

Health Care Costs, Payment & Financing

US health spending reached $3.3 trillion in 2016, and is expected to grow faster than the economy over the next decade. This Almanac report, Health Care Costs 101: A Continuing Economic Threat, details how much is spent on health care in the US, which services are purchased, and who pays.

Intended Consequences: Modernizing Medi-Cal Rate Setting to Improve Health and Manage Costs

Manatt Health, Optumas Healthcare

Medi-Cal, Payment & Financing

The current Medi-Cal rate-setting methodology can hurt health plans that invest in initiatives that lower costs (such as care coordination), thereby discouraging more plans from making those investments. A new rate-setting methodology is needed.

The Health Implications of Tax Reform

December 19, 2017

Billy Wynne, Dawn Joyce, Devin Zatorski

Expanding Health Coverage, Payment & Financing, Telehealth

Tax legislation moving rapidly through Congress has far-reaching implications for health and health care. Three health policy experts summarize the health-relevant components of the Tax Cuts and Jobs Act.

For Better Outcomes and Significant Savings, Medi-Cal Must Pay Health Plans Differently

Christopher Perrone

Medi-Cal, Payment & Financing

California can strengthen its use of payment as a tool to drive performance improvements and create greater value in the Medi-Cal program, and to enhance care for Medi-Cal's more than 13 million members.

Piloting Use of Consensus Standards in Payer-Provider Contracts

Payment & Financing, Serious Illness & End-of-Life Care

Contracting processes between payers and providers to deliver palliative care can often be cumbersome. This project evaluates the use of consensus standards across multiple payer-provider contracts.

Infographic — US Health Care Spending: Who Pays?

Health Care Costs, Payment & Financing

Over the past 60 years, the way health care is financed has changed, with public insurance paying for more care. This graphic shows who paid for health care and how much it cost.

CIN Partners Share: Success in Payment Reform Requires More and Better Data, Plus a Dose of Experimentation

Coverage Trends, Payment & Financing

Amid debate on health care funding in Washington, DC, California Improvement Network partners met to discuss payment reform.