Agenda of overall direction for care delivery & payment reform and timelines Review specific approach for transition to accountable care system Next steps Additional program updates Slide 8 Accountable Care: Topics for discussion today A. CMS Waiver and Federal Investment: - for cost and quality - Goals / framework for distribution and use of funds B. ACO care and payment model, member experience C. Care coordination, community partnership, health homes D. Social determinants of health Slide 9 A. Context on DSRIP Investment Model and CMS Expectations What is Delivery System Reform Incentive Program (DSRIP)? Waiver program in which providers can receive time-limited federal investment to catalyze delivery system improvement Funding at risk and tied to performance metrics Several states have received significant new federal funding under DSRIP waivers, to catalyze/accelerate care delivery reform or implement new payment models Going forward, significant number of other states for funding; process will be “competing” more structured than states receiving earlier investments (OR, NY) Expectations from CMS State commitment to concrete and measurable improvement targets on cost, quality, and member experience Implementation of and broad participation in alternative payment models (APMs) Meaningful delivery system reform, including provider partnerships across the care continuum Confidence in state ability to execute successfully Slide 10 A. CMS Investment and Targets: Concept Overview MassHealth is currently exploring the possibility of applying for funding from CMS to invest in delivery system reform. The idea or concept is that, the more aggressive Massachusetts’ targets are, the larger the anticipated savings, the larger the potential net investment from the federal government. In addition, MassHealth intends to agree to specific reductions in costs off of the current trend and calculate the total expected savings over a 10-year period. This expected savings will represent the figure for which we will apply for funding to investment in delivery system reform.
Agenda of overall direction for care delivery & payment reform and timelines Review specific approach for transition to accountable care system Next steps Additional program updates Slide 8 Accountable Care: Topics for discussion today A. CMS Waiver and Federal Investment: - for cost and quality - Goals / framework for distribution and use of funds B. ACO care and payment model, member experience C. Care coordination, community partnership, health homes D. Social determinants of health Slide 9 A. Context on DSRIP Investment Model and CMS Expectations What is Delivery System Reform Incentive Program (DSRIP)? Waiver program in which providers can receive time-limited federal investment to catalyze delivery system improvement Funding at risk and tied to performance metrics Several states have received significant new federal funding under DSRIP waivers, to catalyze/accelerate care delivery reform or implement new payment models Going forward, significant number of other states “competing” for funding; process will be more structured than states receiving earlier investments (OR, NY) Expectations from CMS State commitment to concrete and measurable improvement targets on cost, quality, and member experience Implementation of and broad participation in alternative payment models (APMs) Meaningful delivery system reform, including provider partnerships across the care continuum Confidence in state ability to execute successfully Slide 10 A. CMS Investment and Targets: Concept Overview MassHealth is currently exploring the possibility of applying for funding from CMS to invest in delivery system reform. The idea or concept is that, the more aggressive Massachusetts’ targets are, the larger the anticipated savings, the larger the potential net investment from the federal government. In addition, MassHealth intends to agree to specific reductions in costs off of the current trend and calculate the total expected savings over a 10-year period. This expected savings will represent the figure for which we will apply for funding to investment in delivery system reform.
1-13-16-public-meeting-slides.docx