nachc internship experience · nachc internship experience alisha reginal public policy intern |...

NACHC Internship Experience

Alisha ReginalPublic Policy Intern | State AffairsNational Association of Community Health CentersApril 21, 2017

Agenda

• Payment Reform • Background

• New Jersey

• Colorado

• Kentucky

• Social Determinants of Health• New York

• Conclusion

Payment Reform

1Instead of PPS, states may implement an Alternative Payment Methodology (APM) to reimburse FQHCs, as long

as each affected FQHC agrees and total reimbursement is not less than it would have been under PPS.

Payment for Performance

Payment for Delivery System Transformation

(PCMH)

Base Payment

(FQHC PPS/APM1)

Incentive

Investment

Flexibility

Payment Reform

1Instead of PPS, states may implement an Alternative Payment Methodology (APM) to reimburse FQHCs, as long

as each affected FQHC agrees and total reimbursement is not less than it would have been under PPS.

Payment for Performance

Payment for Delivery System Transformation

(PCMH)

Base Payment

(FQHC PPS/APM1)

Incentive

Investment

Flexibility

Payment Reform

Payment for Performance

Payment for Delivery System Transformation

(PCMH)

Base Payment

(FQHC PPS/APM1)

Incentive

Investment

Flexibility

Payment Reform

Payment for Performance

Payment for Delivery System Transformation

(PCMH)

Base Payment

(FQHC PPS/APM1)

Incentive

Investment

Flexibility

• Value-Based Payment Models• High-utilizers

• Care Coordination

• Shared Savings

• Value-Based Payment Models• Medicare Shared Savings Program

• Colorado’s Accountable Care Collaborative Plan• Care Coordination

• FQHC APM

• Value-Based Payment Models• PCMH - Care Coordination

• Shared Savings with MCOs

• Medicare Shared Savings Program ACO

Payment Reform Challenges

Payment Reform Impacts

• Quality impacts reimbursement

• Collaboration

• Social Determinants

Social Determinants of Health

https://www.pinterest.com/pin/489907265701462215/

Health Homes

• ACA – Section 2703

• Care coordination and management services for Medicaid beneficiaries with complex healthcare needs

• New York’s criminal justice pilot programs• Develop and test models to connect individuals to healthcare and social-

services post release

• Housing, employment, education, behavioral health, health

• Care managers for Health Homes patients

Conclusions

• Policy and management are intricately interwoven

• Health centers are awesome!

alishareginal6@gwu.edu