State Payment Reform

A Summary from the State of Ohio:

In 2013, Governor Kasich convened a CEO-level Advisory Council on Payment Innovation to help transform Ohio from volume-based fee-for-service payments to value-based payments that reward better health outcomes. The council identified experts to assist the state in designing value-based payment models that (1) support patient-centered medical homes and (2) reduce the incentive to overuse unnecessary services within high-cost episodes of care. Together, these models have the potential to benefit up to 90 percent of the state's population by paying for what works to maintain and improve health while holding down the total cost of care.
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Resources:

>> Find an OSMA Payer Update Session near you!

>> Office of Health Transformation Payment Reform Website
This site includes a number of links to different aspects of the reform process including everything from the initial planning phase to detailed information on the PCMH and Episode roll-out.

>> Ohio Department of Medicaid – Payment Innovation Website
This site includes detailed materials on the PCMH and Episode initiatives. Including design materials for each episodes, sample provider reports, information on risk adjustments, thresholding and FAQs.

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