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Value Based Purchasing
The Maine Health Management Coalition supports its members’ efforts to implement Value Based Purchasing strategies.  Value based purchasing is:
  • The common strategy coalitions across the country are promoting and deploying to reform the healthcare system, community by community.
  • A demand side strategy, involving the actions of coalitions, employer purchasers, public sector purchasers (e.g. Medicare and Medicaid), health plan payers, and individual consumers, to reward excellence in health care delivery. Rewards can take three dominant forms:
    • Enhanced reputation and recognition through public reporting
    • Enhanced payment through differential reimbursement
    • Enhanced market share through purchaser, payer, and/or individual consumer selection
Value based purchasing is not:
  • The supply side strategy of continuous quality improvement espoused by the Institute of Medicine in Crossing the Quality Chasm.

Value based purchasing is a critical external motivator in establishing a business case for why providers of care should embrace, lead, and implement the reengineering of healthcare delivery. 

According to the National Business Coalition on Health and DHHS, the four pillars of Value Based Purchasing must be present in a market to allow employers to implement a Value Based Purchasing strategy.  The four pillars of Value Based Purchasing are:

Pillar One: Standardized Performance Measurement
Standardized performance measurement is the foundation upon which value based purchasing rests.  There is no capacity to reward excellence in healthcare without first measuring performance.

Pillar Two: Transparency and Public Reporting

Standardized performance measures need to be converted into useful information for purchasers, payers, and consumers to inform their decision making, particularly for payment and choice.  Research also demonstrates that public reporting can be a significant external motivator for supply side performance improvement, given the importance of community reputation.

Pillar Three: Payment Reform
There are two critical aspects of payment reform:
  1. The principle of differential reimbursement based on demonstrated performance;
  2. The need to redesign payment methodology to better align economic incentives with desired outcomes. 

Both elements of payment reform are needed and complementary.

Pillar Four: Informed Choice
The challenge here is to encourage demand side participants to choose better performance at all levels of the healthcare system, thus rewarding producers of care with increased market share.

 

Save the Date!

Former NBA superstar Dominique Wilkins will be coming to Portland for 2010 Symposium on Payment Reform. Click HERE for more information!

Attention Physicians!

In our efforts to ensure that physician practice data used to report results in the PTE program is accurate and up-to-date, we are working to update demographic and contact information for physician practices.  Please take a minute to fill out our brief provider database survey HERE .

Provider Ratings

Learn which physician practices and hospitals in Maine provide
safer, high-quality healthcare. Visit
www.mhmc.info

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