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Perspective: Navigating Changing Payment and Care Delivery Models — A View from HIMSS 2015

Perspective: Navigating Changing Payment and Care Delivery Models — A View from HIMSS 2015

This IDC Health Insights Perspective discusses highlights from the all-day preconference symposium held April 12, 2015, as part of the annual HIMSS conference. The preconference symposium discussed the post-health reform industry changes to integrated care delivery and value-based reimbursement (VBR) models. Today's U.S. healthcare environment places a greater emphasis on cost-effectiveness, higher quality of care and outcomes, access to care, and provider and consumer engagement, all of which are challenging providers and payer organizations to change their business models. It is predicted there will be 75 million lives in alternative payment models by 2020, increasing the need for payers and providers to address VBR models and tools sooner rather than later.

The program's content focused on the key considerations and tools required to design and implement changing care delivery and payment models, including discussions on the business and clinical strategies, processes, IT tools, negotiations, and incentives. Measurement of the performance of the U.S. health system in achieving shared goals lies at the heart of this new commitment to accountability and improvement.

In This Perspective
High-Level Themes
Choosing the Best VBR Model from a Payer Perspective
Risk-Related Tools and Provider Reporting
Choosing Quality Measures
Accountable Care Organizations
Payer IT Challenges
Key Considerations
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