We
are finally in a period of rapid change from a volume-based payment system to
one focused on quality and value – and centered on the patient, their family,
and Community. The roots of this effort are not new, drivers for change and
barriers have been known for decades. One
example is the serious Community-wide planning that began in 1995 for New York
State’s Capital Region (comprising the towns and counties around Albany, New
York).
This paper was developed by the multi-stakeholder
Task Force on Managed Care, which was sponsored by the Institute for the
Advancement of Health Care Management of the State University of New York at
Albany (SUNYA). The Task Force met to identify issues and recommendations for a
Risk Model for payment. The Task Force was comprised of a cross section of the
community, including physicians, health provider executives, consumers and
advocates for the disabled, regulators, payers, trade organizations, and
consultants. Periodic meetings were held to define the scope of this concept
paper, to obtain education on managed care issues, and to work through various
drafts of materials. Next Wave staff led
the effort to organize these varied inputs into a framework to focus
understanding and implementation actions and present findings back to the
Community.
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