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Nearly half of all states have value-based targets or mandates, and just seven states have little to no activity around value-based payment models

November 17, 2017 — Alternative payment programs are now firmly rooted in state-level healthcare policy, as discussions regarding health reform continue in Washington, according to a new national study commissioned by Change Healthcare. The study found over 40 states pursuing value-based payment programs, with 15 multi-payer initiatives across those states.

Moreover, 23 states have value-based targets or mandates that payers and providers agreed to achieve, 17 have or are considering adoption of accountable care organizations (ACOs) or ACO-like entities, and 12 have or are considering episodes-of-care programs. Just seven states have little to no activity around value-based payment models, according to the Change Healthcare study.

These insights and more are revealed in Value-Based Reimbursement State-by-State. Published by Change Healthcare, the report and accompanying state-by-state matrix provide a detailed accounting of the alternative payment landscape in all 50 U.S. states plus Puerto Rico and the District of Columbia.

Readers can explore a wide range of approaches taken by the states, as well as examine significant variation in levels of sophistication, leadership commitment and resources devoted to the transition from fee-for-service to alternative payment models.

"This report clearly shows that most of the country is committed to value-based payment as a key component of health reform in order to bend the cost curve and ultimately achieve the Triple Aim," said Carolyn Wukitch, senior vice president & general manager, network and financial management, Change Healthcare. "To scale these complex payment arrangements, payers and providers will need to rely even more on their healthcare information partners to help them model, automate and analyze their programs to ensure cost savings, appropriate care and fast, accurate payment."

Value-Based Reimbursement State-by-State is based on an analysis of publicly available information compiled from May through October 2017. The study relies on information gleaned from primary sources, including state resources, federal government resources and contractors that participate in state-initiated value-based payment programs. In addition, data available from secondary sources was reviewed, including research reports from healthcare industry analysts; mainstream, business and trade media; and think tanks, public policy institutes and research institutes.

The full report is available for download at StateVBRstudy.com. A supporting webinar on Nov. 15, produced in partnership with the HealthCare Executives Group (HCEG), examined state-level value-based payment initiatives. In addition to providing an overview of the report, the webinar featured insights from Brooks Daverman, the director of strategic planning and innovation for TennCare (Tennessee Medicaid), one of the leaders in state-level value-based payment innovation.

For more information: www.changehealthcare.com