On June 16, Ohio Academy of Family Physicians Executive Vice President Ann Spicer joined several other health care organizations at a meeting with Ohio Department of Medicaid (ODM) Director Barbara Sears and the Governor’s Office of Health Transformation Director Greg Moody to get an update on implementation of value-based payment model innovation efforts in Ohio. The two major initiatives are the Ohio Comprehensive Primary Care (CPCOhio) program and implementation of the Episode-Based Payment Model in Medicaid.
CPCOhio
In December 2014, Ohio was awarded a federal State Innovation Model (SIM) test grant to implement a comprehensive primary care payment model that increases access to patient-centered medical homes (PCMH) statewide. PCMH is a team-based care delivery model led by a primary care provider who comprehensively manages a patient’s health needs with an emphasis on health care value and quality. The goal is to give Ohioans the quality of care and information they need to increase their level of health at every stage of life, and to reduce the overall cost of care by improving cost efficiency and care quality.
Episode-Based Payments
In December 2014, Ohio was awarded a federal SIM test grant to implement an episode-based payment model statewide. An episode payment is a single price for all of the services needed by a patient for an entire episode of care. The goal is to reduce the incentive to overuse unnecessary services within each episode, and give health care providers the flexibility to decide what services should be delivered, rather than being constrained by fee codes and amounts.
An announcement from Director Sears regarding the first release of ODM’s Primary Care Clinician Report Card indicates the first report card will be issued to approximately 6,000 primary care physicians through the MITS provider portal on Tuesday, June 27. The ODM website for providers will be updated soon to include an announcement and links to supporting documentation.
In a related matter, Ms. Spicer is also serving on the SIM Evaluation Advisory Group. The evaluation process is being conducted by the Ohio Colleges of Medicine Government Resource Center.