Charting a Path for Health Care Payment Reform

On April 8, 2010, the Robert Wood Johnson Foundation convened a payment reform advisory panel composed of health policy experts as well as representatives of health plans, purchasers, consumer groups, health professionals, government and philanthropy. The panel developed a set of general, high level recommendations to the field of relevant policymakers and health care stakeholders regarding pragmatic next steps necessary for payment reforms.

Reforming payment is a critical piece of the ongoing, years-long effort to help American health care drive sustainable high quality, efficient, and high value care. Most understand that current payment strategies too often promote fragmentation and high volume rather than high value. The recent Patient Protection and Affordable Care Act (PPACA) incorporates this view about the critical nature of payment reform for the overall success of health care reform. The advisory panel made its recommendations against this reform backdrop of heightened attention to and concern about the success of payment reform.

This paper provides a brief summary of the key issues raised by the panel’s discussion and some next step recommendations. It reviews the observations made by the panelists on the key issues stakeholders will face in a post-reform world. It then concludes with recommendations for achieving successful reforms.