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Assessment-based Episode Payment Overview May 30, 2013

PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE. Assessment-based Episode Payment Overview May 30, 2013. 0. PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE. Overview. Arkansas aims to create a sustainable patient-centered health system. Objective. Accountability for the Triple Aim

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Assessment-based Episode Payment Overview May 30, 2013

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  1. PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE Assessment-based Episode Payment Overview May 30, 2013 0

  2. PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE Overview Arkansas aims to create a sustainable patient-centered health system Objective • Accountability for the Triple Aim • Improving the health of the population • Enhancing the patient experience of care • Reducing or controlling the cost of care Care delivery strategies • Population-based care delivery • Risk stratified, tailored care delivery • Enhanced access • Evidence-based, shared decision making • Team-based care coordination • Performance transparency • Episode-based care delivery • Common definition of the patient journey • Evidence-based, shared decision making • Team-based care coordination • Performance transparency Enablinginitiatives Results-based payment and reporting Payment improvement initiative Health care workforce development Consumer engagement and personal responsibility Health information technology adoption SOURCE: State Innovation Plan

  3. PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE Community First Choice Option Assessment-based Episode

  4. PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE Assessment-based episode cycle overview Ono • Episode budget determined • Assessment of need • Onboarding Providers selected Reassessment Services provided Outcomes measured (TBD) • Reassessment timelines could be impacted by significant triggers/changes (TBD) Monthly provider payment

  5. PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE Clients may have multiple providers whereby separate bundle payments will be made based on services outlined in the plan of care Episode budget determined Bundle split by provider Payments mechanics Total episode budget is determined by the universal assessment In the case of multiple providers selected, DHS estimates the portion of budget to be allocated to each provider (based on plan of care) • Respective bundle paid to each provider at predetermined interval (i.e. per month Split bundles All care providers Bundle amount

  6. PRELIMINARY WORKING DRAFT; SUBJECT TO CHANGE Questions

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