Payment Reform
There are health reform provisions that change reimbursement structures and shift financial risk to providers. This section contains information and resources.
Value-Based Purchasing
Billing, Financial Assistance and Collection Practices - Template
HRSA's 340B Prime Vendor Program from National Rural Health Association - PowerPoint Presentation
HRSA's 340B Pharmacy Services Support Center Federal Update from National Rural Health Association - PowerPoint Presentation
HRSA's Office of Pharmacy Affairs 340B Drug Pricing Program from National Rural Health Association - PowerPoint Presentation
Getting Started in the 340B Program: Safety Net Hospitals from National Rural Health Association - PowerPoint Presentation
340B for Newly Eligible Rural Hospitals from National Rural Health Association - PowerPoint Presentation
"Risk Adjustment: Health Calculus for the Reform Environment" from Milliman Inc. Risk adjustment, a method for adjusting health care costs to reflect the health status of a given population, will take on new significance under health care reform. To harness the true potential of such a powerful tool, critical stakeholders like government agencies, health plans, provider organizations and employer groups must understand how to properly select, implement and evaluate risk-adjustment models. Using the appropriate risk-adjustment methodologies in the correct context will contribute to more accurate health care pricing, more efficient utilization and improved quality of care.
Lewin Group Health Benefits Simulation Model HBSM - A micro-simulation model of the U.S. health care system designed to model the effect of policies designed to increase public and private health insurance coverage. It should be thought of as a platform for analyzing the impact of health reform proposals.
Market Basket Adjusment Chart
Medicare Payment Reductions
Health Research and Educational Trust - Bundled Payments - This AHA Research Synthesis Report presents an overview of bundled payment, including evidence of its effects in the public and private sector, as well as questions that must be considered as the concept is carried forward by both policymakers and delivery organizations.