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Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness: Proceedings of a Workshop [Minkštas viršelis]

  • Formatas: Paperback / softback, 94 pages, aukštis x plotis: 229x152 mm
  • Išleidimo metai: 18-Aug-2018
  • Leidėjas: National Academies Press
  • ISBN-10: 0309474442
  • ISBN-13: 9780309474443
Kitos knygos pagal šią temą:
  • Formatas: Paperback / softback, 94 pages, aukštis x plotis: 229x152 mm
  • Išleidimo metai: 18-Aug-2018
  • Leidėjas: National Academies Press
  • ISBN-10: 0309474442
  • ISBN-13: 9780309474443
Kitos knygos pagal šią temą:
Millions of people in the United States live with serious illnesses such as cancer, heart disease, chronic obstructive pulmonary disorder (COPD), amyotrophic lateral sclerosis, Parkinson's disease, and dementiaoften for many years. Those facing serious illness have a range of interconnected medical and non-medical needs, and the way their care is financed has a large impact on the care they receive. Medicare is the predominant payer, but both Medicaid and private payers also play significant roles in financing care for serious illness. In an effort to address the complex needs of people with serious illness, public and private health care payers are testing innovative financing strategies and alternative payment models. These innovative approaches signal a gradual transition from the traditional-fee-for-service system that pays providers based on the quantity of services to a system based on the value of care provided and a heightened focus on improved quality of care at lower cost.





To explore this evolving financing and payment landscape for serious illness care within public- and private-sector programs, the Roundtable on Quality Care for People with Serious Illness developed a workshop, Financing and Payment Strategies to Support High-Quality Care for People with Serious Illness. The workshop convened clinicians, researchers, policy analysts, and patient advocates, as well as representatives from academia, government and private health care plans, and insurers to discuss challenges and opportunities in financing high-quality care for people with serious illness. This publication summarizes the presentations and discussions from the workshop.

Table of Contents



Front Matter Proceedings of a Workshop Appendix A: Statement of Task Appendix B: Workshop Agenda
Acronyms and Abbreviations xix
Introduction 1(7)
Patient--Caregiver--Clinician Perspective On Managing And Paying For Serious Illness Care
8(4)
Framing the Challenges and Opportunites For Financing and Payment Innovation
12(11)
Taking Care of a Seriously Ill Patient in the Context of the Current Health Care Financing System
18(2)
Discussion
20(3)
Exploring Financing And Payment Innovations: Challenges, Impacts, And Lessons From Fee-For-Service And Value-Based Payment Arrangements
23(15)
Financing Serious Illness Care at Cambia Health Solutions
24(2)
CompassionNet: Community-Based Pediatric Palliative Care
26(2)
Anthem's Enhanced Personal Health Care
28(3)
Lessons from CMS Demonstration Projects
31(3)
BSWH's Journey Toward Value in Serious Illness Care
34(2)
Discussion
36(2)
View From Congress
38(2)
Exploring Financing And Payment Innovations: Challenges, Impacts, And Lessons From Global Budgeting Arrangements
40(12)
Financing Quality Care for Serious Illness at Kaiser Permanente
40(3)
Global Payment Arrangements for Serious Illness Care in Massachusetts
43(4)
Complex Care Management at OptumHeakh
47(3)
Discussion
50(2)
Exploring Potential Regulatory And Policy Changes To Ensure High-Quality Care For People Of All Ages With Serious Illness
52(11)
Policy Opportunities
54(4)
Panel Discussion
58(4)
Closing Thoughts
62(1)
References 63(4)
Appendix A Statement of Task 67(2)
Appendix B Workshop Agenda 69