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.

Through the Looking Glass: What’s Behind Hospital Prices for Care

December 20, 2021

Heather Tirado Gilligan

Health Care Costs, Payment & Financing

Glimpses behind the veil of secrecy that surrounds pricing decisions in the health care industry are often shocking and almost always bewildering.

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.

2021 Edition — Health Care Costs 101

Katherine Wilson

Health Care Costs, Payment & Financing

Health Care Costs 101: US Spending Growth Outpaces Economy provides a detailed look at national health care spending in 2019, just prior to the onset of the COVID-19 pandemic.

Health Disparities Require Bolder Action on Medi-Cal Managed Care Contracts

Christopher Perrone

Health Equity, Medi-Cal, Payment & Financing

The draft RFP for Medi-Cal managed care procurement is a significant step forward, but California must do more to eliminate disparities in access and outcomes

Medi-Cal Explained: Managed Care Plan Procurement

Mari Cantwell, Sarah Brooks

Medi-Cal, Payment & Financing

This brief explains what the 2021 Medi-Cal managed care reprocurement process is and what it means for millions of Californians served by Medi-Cal.

A Golden Opportunity to Narrow California’s Racial Health Disparities

The Los Angeles Times Editorial Board

Medi-Cal, Payment & Financing

The state now has a rare opportunity to force health insurers to do more to improve the care that people with low incomes receive through Medi-Cal.

Medi-Cal: California Has a Rare Opportunity to Improve Health Care Equity

Sandra R. Hernández

Medi-Cal, Payment & Financing

About 10 million Californians get their health care through a Medi-Cal managed care plan, but the state's contracts with those plans fail to ensure that these enrollees get the high-quality care they deserve.

The Doctor Will Call Me Maybe

Lori Uscher-Pines, Maggie Jones, Jessica L. Sousa, Zach Predmore, Allison J. Ober

Telehealth, Payment & Financing

Eliminating payment for audio-only telehealth visits will disproportionately affect safety-net settings and patients who are not equipped for video visits.

Use ‘Carrots and Sticks’ to Spur Better Quality, Equity From Medi-Cal Managed Care Plans

February 4, 2021

Christopher Perrone

Medi-Cal, Payment & Financing, Health Equity

California has a rare opportunity to institute long-overdue financial incentives tied to health plan performance.

Paying Medi-Cal Managed Care Plans for Value: Design Recommendations for a Quality Incentive Program

Medi-Cal, Payment & Financing

This report recommends a new way to pay Medi-Cal managed care plans (MCPs) designed to improve the quality of care for Medi-Cal enrollees. The Department of Health Care Services would withhold part of its capitation payments to MCPs, who could earn back some or all of the amount withheld depending on their performance on quality measures.

Video: How Health Center Patients Benefit Under Patient-Centered Payment

Payment & Financing, Medi-Cal

This short animated video explains how old payment rules are hurting three fictional health center patients, Veronica, Michael, and Janelle, and how each would benefit under the switch to patient-centered payment.

Washington Begins Horse Trading over Next Phase of COVID-19 Aid

Billy Wynne, Dawn Joyce

Payment & Financing, Telehealth

A legislative package is expected to pass before Congress adjourns for the August recess.

How Health Centers Can Improve Patient Care Through Value-Based Payment Models

Center for Health Care Strategies

Payment & Financing, Medi-Cal

Patients in health centers across the country are benefiting from state-led value-based payment models that reward high-quality, cost-effective care. The value-based payment models described in this brief aim to provide patients with coordinated, team-based health care that is convenient to access and best meets their needs.

Health Care Costs Accounted for 17.7 Percent of GDP in 2018

Katherine Wilson

Health Care Costs, Payment & Financing

New CHCF Almanac shows hospital care was the biggest spending category.

Time to Modernize Payment to Health Centers

Medi-Cal, Payment & Financing

This issue brief outlines why these old payment rules are hurting patients during the COVID-19 crisis, and how transitioning to a new way of paying for care, called patient-centered payment, will allow health centers to better serve patients going forward.