1. Developing Innovative Payment Approaches: Finding the Path to High Performance Stuart Guterman Vice President, Payment and System Reform The Commonwealth Fund National Academy for State Health Policy 23 rd Annual State Health Policy Conference New Orleans, LA October 6, 2010

4. The Relationship Between Payment Methods and Organizational Models Fee-for-Service Global Case Rates Global Payment Continuum of Payment Bundling Continuum of Organization Small practices; unrelated hospitals Independent Practice Associations; Physician Hospital Organizations Fully integrated delivery system Continuum of Rewards for High Performance Outcome measures; large % of total payment Simple process and structure measures; small % of total payment Blended FFS/Care Management fee Care coordination and intermediate outcome measures; moderate % of total payment More Feasible Source: Adapted from A. Shih, K. Davis, S. Schoenbaum, A. Gauthier, R. Nuzum, and D. McCarthy, Organizing the U.S. Health Care Delivery System for High Performance, The Commonwealth Fund, August 2008. Less Feasible

11. Thank You! For more information, please visit: www.commonwealthfund.org Heather Drake, Program Associate Payment System Reform [email_address]