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Posted: 5:54 p.m. Thursday, Feb. 21, 2013

Ohio receives $3M federal grant to help improve health care payment system

By Randy Tucker

Staff Writer

Gov. John Kasich’s Office of Health Transformation announced Thursday Ohio has received a $3 million federal grant to continue working on a plan to improve the state’s health care payment and delivery systems for Medicaid and Medicare patients and those on commercial health plans.

Ohio’s plan will involve expanding the use of patient-centered medical homes, which bring together doctors, nurses and other medical professionals to improve patient outcomes and reduce costs. It will also include implementing episode-based payments for acute medical events, according to Eric Poklar, a spokesman for the Office of Health Transformation.

“The best way to think of that is paying for a successful procedure rather than the individual components of that procedure,” Poklar said. “Under the fee-for-service payment model we operate under now, you pay for all these little pieces of the whole, which incentivizes more and more pieces; more tests, more medicine.

“What we’re talking about is going to a payment system…where the incentive is to do it right the first time,” he said.

The Office of Health Transformation will lead a design team in partnership with the Governor’s Advisory Council on Payment Innovation, which includes representatives from some of Ohio’s biggest employers, health plans, health systems and consumer advocates.

Ohio was one of 16 states to receive a grant from the Centers for Medicare and Medicaid Services to complete the design phase of a statewide plan, which will then allow the state to apply for a second round of funding later this year to implement the plan.

U.S. Health and Human Services Secretary Kathleen Sebelius announced Thursday her agency was providing nearly $300 million in awards to support 25 participating state and the District of Columbia that are developing and “testing state-based models for multi-payer payment and health care delivery system transformation with the aim of improving health system performance for residents.”

Ohio and its partners will contribute $4.1 million in funding and in-kind resources for the design phase of the plan, according to the Office of Health Transformation.

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