Difference between revisions of "Health Insurance Payment Models"
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| − | These are health insurance payment models that offer incentives for healthcare systems, physicians and patients to design [[interventions]] that improve health behavior, healthcare activities and overall health of patients. They include concerted efforts such to reward healthy behaviors and discourage non healthy actions. See which [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Organization_Interventions_-_What_Works.3F Organization Interventions work]. | + | These are health insurance payment models that offer incentives for healthcare systems, physicians and patients to design [[Non-Medical Interventions|non-medical interventions]] that improve health behavior, healthcare activities and overall health of patients. They include concerted efforts such to reward healthy behaviors and discourage non healthy actions. See which [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Organization_Interventions_-_What_Works.3F Organization Interventions work]. |
| − | == | + | ==Accountable Care Organizations== |
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| − | [http://www.patientdeterminants.org/index.php?title=What_Works%3F# | + | See [[Accountable Care Organizations]] Examples |
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| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Accountable_Care_Organizations_-_What_Works.3F See what works] | ||
| + | |||
| + | ==Care Services== | ||
| + | * Care Management | ||
| + | * Telemendicine | ||
| + | |||
| + | See [[Health Plan - Care Services]] Examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Care_Services_-_What_Works.3F See what works] | ||
| + | |||
| + | ==Episode-Based Payments== | ||
| + | |||
| + | See [[Episode-Based Payments]] Examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Episode-Based_Payments_-_What_Works.3F See what works] | ||
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| + | ==Health Plans Addressing SDOH== | ||
| + | |||
| + | See [[Health Plans Addressing SDOH]] Examples | ||
| + | |||
| + | ==Patient-Centered Medical Homes== | ||
| + | |||
| + | See [[Patient-Centered Medical Homes]] examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Patient-Centered_Medical_Homes_-_What_Works.3F See what works] | ||
| + | |||
| + | ==Patient Incentives== | ||
| + | |||
| + | See [[Patient Incentives]] examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Patient_Incentives_-_What_works.3F See what works] | ||
| + | |||
| + | ==Performance Based Pricing== | ||
| + | |||
| + | See [[Performance Based Pricing]] examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Accountable_Care_Organizations_-_What_Works.3F See what works] | ||
| + | |||
| + | ==Provider-Based Health Plans== | ||
| + | |||
| + | See [[Provider-Based Health Plans]] examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Provider-Based_Health_Plans_-_What_works.3F See what works] | ||
| + | |||
| + | ==Value-Based Care Programs== | ||
| + | * [http://www.beckershospitalreview.com/payer-issues/unitedhealthcare-of-florida-awards-physicians-2m-in-bonuses-tied-to-quality.html UnitedHealthcare of Florida awards physicians $2M in bonuses tied to quality (2/27/17)] | ||
| + | * [http://www.fiercehealthcare.com/practices/as-macra-ramps-up-study-says-no-evidence-pay-for-performance-improves-outcomes Study says no evidence pay-for-performance improves outcomes (1/11/17)] | ||
| + | * [http://healthpayerintelligence.com/news/how-3-healthcare-insurers-expand-value-based-care-payment Blue Cross Blue Shield health plans, Cigna, and UnitedHealthcare are leading the way in alternative reimbursement structures such as bundled payment models and shared saving programs to expand their value-based care payment footprint in recent years. (1/17/17)] | ||
| + | * [http://healthpayerintelligence.com/news/humana-aetna-cigna-invest-in-value-based-care-payment-models Humana, Aetna, Cigna Invest in Value-Based Care Payment Models (1/6/17)] | ||
| + | * [https://www.forbes.com/sites/brucejapsen/2017/02/02/unitedhealth-aetna-anthem-near-50-value-based-care-spending/#11badd761d4e UnitedHealth, Aetna, Anthem Near 50% Value-Based Care Spending (2/2/17)] | ||
| + | * [https://www.thestreet.com/story/13664638/2/doctors-earn-more-than-148-million-in-quality-of-care-bonus-payments-for-improving-health-outcomes-addressing-care-opportunities-for-unitedhealthcare-medicare-advantage-members.html Doctors Earn More Than $148 Million In Quality Of Care Bonus Payments For Improving Health Outcomes, Addressing Care Opportunities For UnitedHealthcare Medicare Advantage Members (8/4/16)] | ||
| + | * [http://www.beckershospitalreview.com/accountable-care-organizations/4-strategies-bcbs-used-to-save-1b-through-patient-centered-programs.html 4 strategies BCBS used to save $1B through patient-centered programs. These programs include BCBS' accountable care organizations, patient-centered medical homes, pay-for-performance programs and episode-based payment programs — emphasize prevention, wellness and coordinated care, in conjunction with reducing waste in the healthcare delivery system. (6/2/15)] | ||
| + | |||
| + | See [[Value-Based Care Program]] examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Value-Based_Care_Programs_-_What_Works.3F See what works] | ||
| + | |||
| + | ==Value-Based Insurance Design== | ||
| + | Health plan benefit design to increase health care quality and decrease costs by using financial incentives to promote cost efficient health care services and consumer choices | ||
| + | |||
| + | See [[Value-Based Insurance Design]] examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Value-Based_Insurance_Design_-_What_Works.3F See what works] | ||
| + | |||
| + | ==Wellness Payment Models== | ||
| + | |||
| + | See [[Wellness Payment Models]] examples | ||
| + | |||
| + | [http://www.patientdeterminants.org/index.php?title=What_Works%3F#Wellness_Payment_Models_-_What_Works.3F See what works.] | ||
Latest revision as of 18:46, 18 February 2019
These are health insurance payment models that offer incentives for healthcare systems, physicians and patients to design non-medical interventions that improve health behavior, healthcare activities and overall health of patients. They include concerted efforts such to reward healthy behaviors and discourage non healthy actions. See which Organization Interventions work.
Contents
- 1 Accountable Care Organizations
- 2 Care Services
- 3 Episode-Based Payments
- 4 Health Plans Addressing SDOH
- 5 Patient-Centered Medical Homes
- 6 Patient Incentives
- 7 Performance Based Pricing
- 8 Provider-Based Health Plans
- 9 Value-Based Care Programs
- 10 Value-Based Insurance Design
- 11 Wellness Payment Models
Accountable Care Organizations
See Accountable Care Organizations Examples
Care Services
- Care Management
- Telemendicine
See Health Plan - Care Services Examples
Episode-Based Payments
See Episode-Based Payments Examples
Health Plans Addressing SDOH
See Health Plans Addressing SDOH Examples
Patient-Centered Medical Homes
See Patient-Centered Medical Homes examples
Patient Incentives
See Patient Incentives examples
Performance Based Pricing
See Performance Based Pricing examples
Provider-Based Health Plans
See Provider-Based Health Plans examples
Value-Based Care Programs
- UnitedHealthcare of Florida awards physicians $2M in bonuses tied to quality (2/27/17)
- Study says no evidence pay-for-performance improves outcomes (1/11/17)
- Blue Cross Blue Shield health plans, Cigna, and UnitedHealthcare are leading the way in alternative reimbursement structures such as bundled payment models and shared saving programs to expand their value-based care payment footprint in recent years. (1/17/17)
- Humana, Aetna, Cigna Invest in Value-Based Care Payment Models (1/6/17)
- UnitedHealth, Aetna, Anthem Near 50% Value-Based Care Spending (2/2/17)
- Doctors Earn More Than $148 Million In Quality Of Care Bonus Payments For Improving Health Outcomes, Addressing Care Opportunities For UnitedHealthcare Medicare Advantage Members (8/4/16)
- 4 strategies BCBS used to save $1B through patient-centered programs. These programs include BCBS' accountable care organizations, patient-centered medical homes, pay-for-performance programs and episode-based payment programs — emphasize prevention, wellness and coordinated care, in conjunction with reducing waste in the healthcare delivery system. (6/2/15)
See Value-Based Care Program examples
Value-Based Insurance Design
Health plan benefit design to increase health care quality and decrease costs by using financial incentives to promote cost efficient health care services and consumer choices
See Value-Based Insurance Design examples
Wellness Payment Models
See Wellness Payment Models examples
