The landscape of health care is shifting. Providers are increasingly being reimbursed for the value of the care they provide, rather than the number of services. Public health systems are at the forefront of this shift to value-based care, participating in new incentive programs and risk arrangements that align payment with programs that keep patients healthy. Our most recent publication, California’s Public Health Care Systems’ Journey to Value-Based Care, describes how California’s public health care systems have been leading efforts to evolve safety net payments from volume to value over the past decade.
In California, the Medi-Cal 2020 waiver has been a key stepping stone for public health care systems to succeed in the new value-based care environment. The pay-for-performance program, PRIME, incentivizes a greater focus on preventive services and ambulatory care, as well as more efficiency in inpatient care. The Whole Person Care program supports coordination across providers – not just within a health care system but between safety net agencies and community-based organizations serving the entire county. And the Global Payment Program aligns payment with improvements in care for the remaining uninsured. Each waiver program builds the core competencies that will allow public health systems to thrive in an evolving value-based payment system.
To find out more about how the Medi-Cal 2020 Waiver supports value-based strategies, download our Issue Brief on the waiver.