Focusing on appropriateness, care variation, and person-centered care for all patients through dissemination of best practices.
Reducing disparities and improving health equity through reallocation of resources to address SDOH (e.g., housing, food insecurity, transportation).
Improving predictability for providers through improved risk adjustment for complex patients, offering stronger incentive structures for Medicaid beneficiaries, and flexibility on waivers.
Providers who are successful in FFS may lack a compelling reason to transition to APMs, but may be unable to compete with the person-centered care delivered by providers in APMs. Introducing APMs through multi-payer pilots in these markets (particularly for independent and smaller providers) may increase competition and reduce FFS entrenchment.
Ensuring providers adopt timely data and analytics capabilities, combining multiple data sources (e.g., electronic health record and claims data), to enable successful participation in value-based payment models.
Providing patients and caregivers with cost, quality, and appropriateness of care data in an actionable, easily understood, and accessible manner. Ensuring that electronic data can be easily shared meeting advanced technology standards (e.g., HL7 FHIR) to improve care delivery.