A number of potential payment models and contracting strategies have emerged as possible replacements for the current fee-for-service payment system in both public programs (e.g., Medicare and Medicaid) and commercial health plans. This session will look at these evolving models—including value-based purchasing, bundled payments, shared savings programs and accountable care organizations (ACOs), and population health management and global payments—and discuss possible pros and cons of these different models. 

Specific topics will include: 

  • Provisions of the Affordable Care Act relating to value-based purchasing, hospital acquired conditions (HACs), the Medicare Shared Savings Program (MSSP), Pioneer ACOs, and the Readmissions Reduction Program
  • Value-based payment efforts by the commercial payer community and direct contracting arrangements with employers
  • Developments in the health insurance exchanges, including the emergence of narrow networks
  • Overview of key contracting considerations for different payment models
  • Organizational success factors for implementing these models

Leader: Melinda Hancock, CPA, FHFMA is a Partner with Dixon Hughes Goodman LLP