Delivery System and Payment Model Redesign

Building new models that get results

More accountable healthcare will require delivery and payment systems that focus on quality, not volume. And developing these systems is one of the biggest challenges of healthcare reform. It will require better integration and coordination—not only between healthcare industry players, but also with the patients who receive care.

To help make that happen, we’ve created a team of clinical, financial and administrative experts dedicated exclusively to building these new delivery and payment models. They’re already working with payers and providers to build more effective, efficient systems. Our services include:

  • Identifying health services that best meet the needs of individual populations using demographics, health status and trends, health risks and patterns of utilization
  • Implementing innovations and evidence-based approaches to providing value-based healthcare, including HMA’s Risk Ready Primary Care model
  • Developing strategies to transition providers away from volume-based reimbursement and toward payment based on quality and outcomes
  • Integrating primary care and behavioral health services with financing and programmatic strategies
  • Coordinating physical and behavioral healthcare with housing, employment and other vital support systems
  • Implementing Patient Centered Medical Homes (PCMH) and Health Homes that use team-based care
  • Coordinating primary care with specialty, inpatient, behavioral health and long-term services and supports
  • Driving better care management that includes risk assessment of patients and populations, self-management support, coordination of long-term services and supports and transitioning patients from inpatient and emergency care
  • Designing and implementing effective team-based care, including training, mentoring and coaching of new workforce roles
  • Identifying and implementing new ways to integrate services within health centers and across care settings