Population-based payment (PBP) models are an advanced value-based payment approach that offers health care providers upfront, flexible payments, and a reprieve from the hamster wheel of patient visits that fee-for-service payment models incentivize. States that implement PBP models in their Medicaid programs have designed these models to achieve often hard-to-reach health care goals, such as controlling costs, improving quality and outcomes, enhancing patient and provider experience, and promoting health equity. With interest in PBP models in Medicaid growing, insights from pioneering states can help inform other states considering their own PBP models.
This webinar, made possible with support from Arnold Ventures, highlighted findings from a Center for Health Care Strategies (CHCS) report on early lessons for using PBP models in Medicaid. It featured a panel discussion with officials from Colorado, Massachusetts, and Pennsylvania — three states that have launched PBP models. State officials shared perspectives on designing and implementing Medicaid PBP models focused on primary care, total cost of care, and hospital care. Panelists discussed design considerations required for models that cover different scopes of services and explored the challenges and successes of these models to date.
I. Welcome and Introduction
Speakers: Rob Houston, MBA, MPP, Director of Delivery System and Payment Reform, CHCS and Amber Burkhart, MA, MS, Health Care Manager, Arnold Ventures
R. Houston welcomed participants and provided an overview of the webinar. A. Burkhart provided introductory remarks on behalf of Arnold Ventures.
II. Overview of Medicaid Population-Based Payment Models
Speaker: Anne Smithey, MPH, Program Officer, CHCS
A. Smithey shared findings from CHCS’ research into Medicaid PBP models. She explored the current landscape of PBP model design and implementation in Medicaid, detailed insights from existing and emerging models, and offered considerations for policymakers interested in developing or increasing adoption of PBP models.
III. Exploring State Models in Colorado, Massachusetts, and Pennsylvania
Moderator: Rob Houston, CHCS
- Trevor Abeyta, MA, Payment Reform Section Manager, Colorado Department of Health Care Policy & Financing
- Martha Farlow, MHA, Deputy Director of Policy, MassHealth; and
- Janice Walters, MSHA, CHFP, Chief Operating Officer, Pennsylvania Rural Health Redesign Center
R. Houston facilitated a panel exploring varying approaches to Medicaid PBP models in Colorado, Massachusetts, and Pennsylvania. Speakers provided an overview of their model, shared why they chose to implement a PBP model, described key design and implementation considerations, and highlighted successes and challenges.