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March 2013 St@teside

Payment Reform Return on Investment Case Studies Released

As health care costs rise, employer purchasers are increasingly conscious of the effect of these expenses on their bottom line. This awareness has prompted more interest among employers to move away from the predominant fee-for-service “pay-for-volume” approach and experiment with different types of payment reform. The decision to modify how employer purchasers pay for their employees’ health care costs has important financial implications. Therefore, before making the decision to participate in a new payment reform model, employer purchasers are interested in seeing if these efforts provide a potential positive return on investment (ROI).
Bailit Health Purchasing, LLC has recently completed a series of briefs examining the ROI for various types of payment reforms. These briefs were completed as part of a Robert Wood Johnson Foundation (RWJF) grant to AcademyHealth that offers technical assistance to RWJF payment reform grantees, fosters collaboration and cross-grantee learning, and disseminates these lessons more broadly. 
The first brief in the series provides a high-level synthesis of the information highlighted in each of the specific case studies. Each additional brief in the series is organized around a specific type of payment reform (bundled payment, population-based payment, patient-centered medical homes, and high-intensity primary care), and provides case studies demonstrating examples of employer purchasers who have undergone payment reform and are experiencing either a positive ROI or are on the path to a positive ROI.