Payment Reform Toolkit
What if your state could save millions of dollars in its Medicaid program next year and improve patient care? By implementing smart payment reforms, it can.
Introduction to Smart Payment Reform
Too many patients become sicker during their hospital stay, or leave the hospital without the instructions or follow-up care needed to avoid a return trip within days or weeks after their discharge.
These problems - referred to as potentially preventable complications or readmissions - have serious and negative consequences for patients' health, and they also drive up health care costs for everyone. We can change this cycle by changing the way our states pay hospitals.
States can save millions while improving care by reforming their payment systems to reflect this common-sense concept: hospitals with higher rates of potentially preventable complications and readmissions should get paid a little less than hospitals that do a better job at avoiding these harmful events.
Resources on Smart Payment Reform
- Model legislation: see our overview and model legislative language for implementing this type of payment reform in your state
- Smart Payment Reforms Can Reduce Costs and Improve Quality: A Short Primer offers detailed information about implementing this type of payment reform in your Medicaid program
- Medicaid Payment Reform Could Save States Billions shares state-by-state estimates for annual savings if payment reforms are implemented
- Payment Reform: Addressing Hospital Concerns provides talking points and policy options for dealing with opposition from the hospital industry
We Want to Hear From You
Are you thinking of advocating for this type of payment reform in your Medicaid program? Community Catalyst would love to hear about your experience or provide you with further resources. Please contact Katherine Howitt, policy analyst at Community Catalyst.