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Coping with Fragmented Payment in the Real World

Friday, April 13, 2012

Many analysts and policymakers agree that the fragmentation of the health care delivery system results in uncoordinated care, frustrated patients, higher costs, wasted administrative dollars and lost opportunities for rapid improvement in our health care system. There is less agreement as to how to reform health care payments in order to harmonize health care delivery and reduce this fragmentation. How do institutions, communities and practitioners transform their organizations to deliver high-quality, patient-centered care when different payers pay at different rates, and some patients have no one paying at all?

To answer this important question and related ones, the Alliance for Health Reform and The Commonwealth Fund sponsored an April 13 briefing. Speakers were: Steve Safyer, Montefiore Medical Center, NY; Gregory Reicks, Grand Junction, CO; John Colmers, Johns Hopkins Medicine, who chairs the Maryland Health Services Cost Review Commission; and Jim Bentley, health policy consultant, Silver Spring, Maryland. Stuart Guterman of Commonwealth and Ed Howard of the Alliance co-moderated.

These experts focused on three communities that have reformed and harmonized health care payments across payers to improve care: a New York health system that serves a low income population; a Colorado community that pools money from public and private sources to provide care for all patients; and the State of Maryland, which has been using an all payer hospital rate setting system for years to control hospital costs and help cover the cost of care for their uninsured.


 Stu Guterman, The Commonwealth Fund, Moderator
 Steve Safyer, Montefiore Medical Center, NY, Speaker
 Gregory Reicks, Foresight Family Physicians, Grand Junction, CO, Speaker
 John Colmers, Maryland Health Services Cost Review Commision, Speaker
 Jim Bentley, Health Policy Consultant, Silver Spring, MD, Speaker
(Click on the camera icon to see a video of the speaker's presentation.)

Transcript, Event Summary and/or Webcast and Podcast

Transcript: Coping With Fragmented Payment in the Real World (Adobe Acrobat PDF), 4/24/2012
Full Webcast/Podcast: Coping with Fragmented Payment in the Real World

The full webcast and podcast for this briefing, as well as videos of individual speakers' presentations, are provided by Kaiser Family Foundation.

Speaker Presentations

Stuart Guterman's presentation (PowerPoint), 4/13/2012
Steve Safyer's Presentation (Adobe Acrobat PDF), 4/13/2012
Gregory Reicks's Presentation (PowerPoint), 4/13/2012
John Colmers's Presentation (PowerPoint), 4/13/2012

(If you want to download one or more slides from these presentations, contact us at info@allhealth or click here for instructions.)

Source Materials

Agenda (Word Document), , 4/13/2012
Speaker Biographies (Adobe Acrobat PDF), , 4/13/2012
Materials List (Adobe Acrobat PDF), , 4/13/2012
Source List (Adobe Acrobat PDF), , 4/13/2012

Offsite Materials (briefing documents saved on other websites)

Testimony to the Joint Committee on Health Care Financing (Adobe Acrobat PDF),Pioneer Institute, 5/1/2011
- Joshua Archambault
Accountable Care Organizations in Medicare and the Private Sector: A Status Update, Urban Institute and Robert Wood Johnson Foundation, 11/1/2011
- Robert Berenson and Rachel Burton
Next Step for ACOs: Will This New Approach to Health Care Delivery Live Up to the Dual Promises of Reducing Costs and Improving Quality of Care?, Health Affairs, 1/31/2012
- Robert Berenson and Rachel Burton
Montefiore Medical Center: Integrated Care Delivery for Vulnerable Populations, Commonwealth Fund, 10/1/2010
- Deborah Chase
Maryland’s All-Payor Hospital Payment System, The Maryland Health Services Cost Review Commission, 3/1/2009
- Harold Cohen
The End of Health Insurance Companies, New York Times, 1/30/2012
- Ezekiel Emanuel and Jeffrey Liebman
Cost Control the Next Step for Massachusetts Health Reform, American Medical News, 3/28/2011
- Tanya Albert Henry
How Much Was That Treatment? , New York Times, 3/24/2012
Expect the Unexpected? Physicians’ Responses to Payment Changes (Adobe Acrobat PDF),National Institute for Health Care Management , 11/1/2010
-  Mireille Jacobson and Joseph Newhouse and John MacArthur.
New Method Needed for Setting Health Care Payment Rates, Experts Say, Commonwealth Fund, 10/25/2010
Grand Junction, Colorado, A Health Community That Works (Adobe Acrobat PDF),New America Foundation, 8/1/2009
-  Len Nichols and Micah Weinberg and Julie Barnes
Why Accountable Care Organizations Won’t Deliver Better Health Care – and Market Innovation Will, Heritage Foundation, 4/18/2011
- Rita Numerof
Setting Hospital Rates to Control Costs and Boost Quality: The Maryland Experience, Health Affairs , 9/1/2009
- Robert Murray
The Many Different Prices Paid to Providers and the Flawed Theory of Cost Shifting: Is It Time For a More Rational All-Payer System? (Adobe Acrobat PDF),Health Affairs , 11/1/2011
- Uwe Reinhardt
“In Praise of Price-Fixing, National Journal , 3/19/2012
- Margot Sanger-Katz
Single Payer Ahead – Cost Control and the Evolving Vermont Model, The New England Journal of Medicine, 8/18/2011
- Anya Rader Wallack
Grand Junction, Colorado: A Health Community That Works (Adobe Acrobat PDF),New America Foundation, 8/1/2009
- Len Nichols and Micah Weinberg and Julie Barnes


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