NACHC Internship Experience · NACHC Internship Experience Alisha Reginal Public Policy Intern |...
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NACHC Internship Experience Alisha Reginal Public Policy Intern | State Affairs National Association of Community Health Centers April 21, 2017
Transcript of NACHC Internship Experience · NACHC Internship Experience Alisha Reginal Public Policy Intern |...
NACHC Internship Experience
Alisha ReginalPublic Policy Intern | State AffairsNational Association of Community Health CentersApril 21, 2017
Agenda
• Payment Reform • Background
• New Jersey
• Colorado
• Kentucky
• Social Determinants of Health• New York
• Conclusion
Payment Reform
1Instead of PPS, states may implement an Alternative Payment Methodology (APM) to reimburse FQHCs, as long
as each affected FQHC agrees and total reimbursement is not less than it would have been under PPS.
Payment for Performance
Payment for Delivery System Transformation
(PCMH)
Base Payment
(FQHC PPS/APM1)
Incentive
Investment
Flexibility
Payment Reform
1Instead of PPS, states may implement an Alternative Payment Methodology (APM) to reimburse FQHCs, as long
as each affected FQHC agrees and total reimbursement is not less than it would have been under PPS.
Payment for Performance
Payment for Delivery System Transformation
(PCMH)
Base Payment
(FQHC PPS/APM1)
Incentive
Investment
Flexibility
Payment Reform
Payment for Performance
Payment for Delivery System Transformation
(PCMH)
Base Payment
(FQHC PPS/APM1)
Incentive
Investment
Flexibility
Payment Reform
Payment for Performance
Payment for Delivery System Transformation
(PCMH)
Base Payment
(FQHC PPS/APM1)
Incentive
Investment
Flexibility
• Value-Based Payment Models• High-utilizers
• Care Coordination
• Shared Savings
• Value-Based Payment Models• Medicare Shared Savings Program
• Colorado’s Accountable Care Collaborative Plan• Care Coordination
• FQHC APM
• Value-Based Payment Models• PCMH - Care Coordination
• Shared Savings with MCOs
• Medicare Shared Savings Program ACO
Payment Reform Challenges
Payment Reform Impacts
• Quality impacts reimbursement
• Collaboration
• Social Determinants
Social Determinants of Health
https://www.pinterest.com/pin/489907265701462215/
Health Homes
• ACA – Section 2703
• Care coordination and management services for Medicaid beneficiaries with complex healthcare needs
• New York’s criminal justice pilot programs• Develop and test models to connect individuals to healthcare and social-
services post release
• Housing, employment, education, behavioral health, health
• Care managers for Health Homes patients
Conclusions
• Policy and management are intricately interwoven
• Health centers are awesome!
