Office of Health Transformation Update June 14, 2016
Ohio Advances Value-Based Payment Models
Last week the Governor's Office of Health Transformation hosted two webinars to update health care providers on Ohio's progress to financially reward practices that improve health outcomes while holding down the total cost of care.
Comprehensive Primary Care Payment Model. On June 8, Ohio Medicaid and the state's four largest commercial health insurance plans applied to the federal government to designate Ohio a statewide comprehensive primary care (CPC) region. If selected, Medicare, Medicaid and the commercial plans agree to provide enhanced reimbursement for advanced primary care beginning in January 2017.
Episode-Based Payment Model. OHT reported that Ohio Medicaid is currently sending performance reports to the specialists primarily responsible for 13 high-cost episodes of care (commercial plans are using similar reports), and announced plans to design an additional 30 episodes in 2016. The information in the performance reports will be converted into referral reports for primary care practices to assist them in connecting their patients to high-value specialists.