Setting the Stage

Payment reform is a hot topic debated amongst health care professionals everywhere.  The uncertainty and confusion about the potential approaches and models for change are creating anxiety and in some instances cutting careers short, as in the case of Walter Sensor of Alegent Health in Omaha, Nebraska. (For a great summary of the lessons learned about implementing change, view an exclusive interview with Wayne Sensor. The summary bullets on page two are particularly insightful.)

We have developed a high-level outline of the key elements and proposed models for health payment reform in the model below. We welcome your feedback about whether or not we have identified the key concepts, tools, methods, and potential examples adequately.  Our goal throughout the coming weeks is to explore each of the concepts and models by discussing the lessons learned, the potential shortcomings or problems with current methods, and some of the key ways providers need to begin to evaluate their organizations readiness for payment reform. We believe that real change to reimbursement is coming, and that it will likely be implemented over a three-to-five year horizon. However, the array of organizational changes required really means that it is important to evaluate our current capabilities and develop a plan to implement the process changes needed so the pace of change will be tolerable to both our staffs and our physician partners.

Potential Payment Reform Elements and Models