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The traditional health care reimbursement path contributes to unnecessary spending and fragmented care. Value-based payment is a reimbursement method for health care services aimed at rewarding value (quality of health care), not volume (fee-for-service).
The state is using its purchasing power to lead by example and accelerate the adoption of value-based reimbursement and alternative payment strategies. HCA is working with other private and public health care purchasers to further spread the paying for value strategy and accelerate market transformation.
Implementing a new model
In 2016, HCA offered three new medical plan options for enrollees in HCA’s Public Employees Benefits Board (PEBB) Program. This model tests an accountable care plan approach. Under this shared risk model, accountable care network providers assume financial and clinical responsibility for a defined population of public employees.
Employers are invited to review the following contracting documents to support their own adoption of accountable care and value-based purchasing.
The Value-based Purchasing Toolkit is comprised of two parts:
- The Value-based Purchasing Guide provides an overview of the principles behind value-based purchasing, and offers links to tools and resources.
- The Toolkit also includes a series of downloadable documents based on HCA’s successful contracting materials for an accountable care plan. The materials below can help the decision-maker take the next steps in their own health care contracting process.
ACP contract materials
ACP contract attachments and exhibits
- Partner information request
- Geographical analysis
- Alternative payment models template
- Quality measures form
- Partner request attestations