Innovation Models of Care & Value Based Payment Plan Discussion

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Go to the CMS Innovation website and select a payment and service-delivery model related to payment and quality reform. The “Innovation Models” page provides a list of models. All of these models relate to payment and quality reform, but in different ways. Select a model of interest and think about how the specific model relates to payment and quality reform.

Then, in your post, address the following:

• Explain the need to move from a volume-based to value-based payment plan.
• Discuss the specific model and how it will impact the Triple Aim of quality, equity, and efficiency.

Response Posts:
In response to at least two of your peers, compare how the Triple Aim of equality, equity, and efficiency has impacted the payment and delivery model you chose against the choices of your peers.

Which aim do you think the reform has the most impact upon? Do you think the model will be able to endure the test of time? How would the model impact you as a healthcare professional?

peer 1: I chose the Regional Budget Payment Concept because I have lived in a rural area most of my life, and the concept of furthering medical facilities and care in rural area’s interests me. My mom and sister both have ailments that require specialists, and because of the rural area we live in, they have to travel to see these doctors.

CMS wants to make local providers accountable for community health by allotting a budget for the specific community under these providers care. This will make more doctors want to come to rural areas because this will give them specific revenue expectation’s, and CMS will provide incentives tailored to the specific communities. This model will impact triple aim by encouraging quality care by bringing providers to rural areas, by making sure everyone in their community is cared for equally, and by doing this efficiently their goals will be achieved quicker and more easily.

When moving to value based from volume based payment plans with this model, once providers have achieved a better community health there will be less money spent on taking care of preventable issues, and more spent on caring for unpreventable issues, giving providers more money in the budget for state of the art equipment needed to care for their patients.

CMS. (2020). Regional Budget Payment Concept. Retrieved from https://innovation.cms.gov/innovation-models/regio…

peer 2: The innovation model I chose to discuss is the Independence at Home Demonstration. Under this model, this allows the patients to receive primary care at home environment. The point of this is model is so chronically ill patients can stay home and participating provides can make the visits for patient needs and coordinate their care. The Independence at Home Demonstration states, “CMS will track the beneficiary’s care experience through quality measures. Practices that succeed in meeting these quality measures while generating Medicare savings will have an opportunity to receive incentive payments after meeting a minimum savings requirement.” (CMS 2020). Not only this allows the patient to be at his/her to receive care at their time and convenience, the participating provider will receive for payment and incentive for quality treatment given to the patient.