246359 How payment and quality reforms incentivize integrated care

Tuesday, November 1, 2011: 9:27 AM

Kelly J. Kelleher, MD, MPH , Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH
Deena Chisolm, PhD , Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH
Federal efforts to simultaneously expand access to care and control health care costs have resulted in a number of new efforts to incentivize value through new payment models and quality reporting requirements. Provisions creating new quality reporting programs can be found in the Children's Health Insurance Program Reauthorization (CHIPRA) and the Health Information and Technology for Clinical and Economic Health (HITECH) Act of 2009. The federal health care reform bill, the Patient Protection and Affordable Care Act (commonly referred to as ACA), also authorized new quality measure development and reporting. These quality measure sets will be used to spur quality improvement through reporting and transparency, but the measures also will be tied to payment incentives and, eventually, to proposed payment penalties. The ACA created the new Center for Medicare and Medicaid Innovation and authorized the formulation of new payment models, such as the Patient Centered Medical Home initiative and Accountable Care Organizations. These payment models emphasize communication between health providers, and they will likely be defined with the help of quality measure reporting. This presentation will provide an overview of various payment and quality reforms at the federal level and how they can be leveraged to promote the integration of mental and general health care.

Learning Areas:
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Describe new quality reporting and payment models. Analyze and explain how new quality reporting and payment models promote integrated care.

Keywords: Public Policy, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to be an author on this content because I am an active research in teen behavioral health and health policy.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.