Provider payment and delivery systems

What characteristics of provider payment mechanisms influence ...

Provider payment mechanisms (PPMs) create incentives or signals that influence the behaviour of health care providers.

42 CFR Part 447 -- Payments for Services - eCFR

Payment for any service furnished to a beneficiary by a provider may not be ... services to Medicaid beneficiaries through a fee-for-service delivery system.

Medicaid: An Overview - CRS Reports

administer its program (e.g., eligibility requirements, benefit coverage, provider reimbursement, delivery systems) and certifies that the ...

Solving Disparities Through Payment And Delivery System Reform

Care transformations can reduce disparities,, and simultaneously many providers, payers, and policy makers have been experimenting with payment reform as they ...

Pass-through payment guidance in final Medicaid managed care ...

Currently, for services provided on a fee-for-service basis, providers may receive supplemental payments to enhance reimbursement, subject to ...

Engaging Providers in Building Managed Care Delivery Systems

Providers can serve as an important channel for communication with state policymakers and administrators about how the managed care program is faring. Providers ...

Medicaid Program; The Use of New or Increased Pass-Through ...

States that do not have pass-through payments in their managed care contracts that wish to pursue delivery system and provider payment ...

How States Are Leveraging Payment to Improve the Delivery of SUD ...

Several leading states have begun using payment – to providers and/or to managed care organizations – to target improvements in SUD systems. The experience of ...

Provider Information - myDSS - MO.gov

MO HealthNet assigns individuals to either the Fee-For-Service program or a Managed Care health plan depending on eligibility criteria. man in wheelchair with a ...

Effects of mixed provider payment systems and aligned cost sharing ...

Paying providers is a complex process with most countries applying a mix of provider payment methods (PPMs), i.e. there are at least two payment ...

GAO-22-105731, Medicaid: State Directed Payments in Managed ...

Services, Delivery System and Provider Payment Initiatives under Medicaid Managed Care Contracts, Informational. Bulletin (Baltimore, Md ...

Directed Payments Program - DHCS - CA.gov

The result is changes in the usage of managed care delivery systems, CFR section 438.6 (c) provides State's flexibility to implement delivery ...

The Effect of Provider Payment Systems on Quality, Cost and ...

It is important to note that there are other incentives involved in the delivery of health care, besides financial incentives offered to health care providers.

Innovative providers' payment models for promoting value-based ...

This led to financial stress for providers and put healthcare systems under pressure to reorganise the delivery of care, and to increase capacities, where ...

Provider Relief - HRSA

The Provider Relief Bureau (PRB) ensured resiliency of the nation's health care systems ... Distribution, including no reconsideration payments. Likewise, no ...

Healthcare Payment Glossary - Definitions

A provider who accepts responsibility for ensuring that a payment is used to produce the results that are expected, whether that be the delivery of one or more ...

IHCP Programs and Services - Indiana Medicaid: Providers - IN.gov

The fee-for-service (FFS) delivery system reimburses providers on a per-service basis. Generally, members seek services from IHCP providers of their choice. The ...

State Directed Payment Programs

Part 438 govern how states may direct plan expenditures in connection with implementing delivery system and provider payment initiatives under Medicaid managed ...

Provider payment methods and strategic purchasing for UHC

deliver, how they deliver them and the mix of inputs they use. The right incentives can direct provider behaviour in a way that serves health system goals such ...

Key Takeaways for States, Providers and Plans on State Directed ...

... Payments and Separate Payment Terms. Health ... provider payment methodologies that promote access, quality, and delivery system reform.