Documenting New Ways of Delivering Care Under Oregon’s Alternative Payment and Advanced Care Model

Journal of the American Board of Family Medicine: JABFM

article

Erika K. Cottrell¹  Katie Dambrun²  Jean O’Malley¹  R. Lorie Jacob²  Ned Mossman²  Charles Ashou³  John Heintzman¹ 

[1] From the Department of Family Medicine, Oregon Health & Science University;Inc.;Virginia Garcia Memorial Health Center

关键词: Capitation Fee;    Community Health Centers;    Health Care Systems;    Health Policy;    Medicaid;    Oregon;    Organizational Innovation;    Patient-Centered Care;    Primary Health Care;    Workforce;   

DOI  :  10.3122/jabfm.2021.01.200027

学科分类：过敏症与临床免疫学

来源: The American Board of Family Medicine

【 摘 要 】

Background: The fee-for-service reimbursement system that dominates health care throughout the United States links payment to a billable office visit with a physician or advanced practice provider. Under Oregon’s Alternative Payment and Advanced Care Model (APCM), initiated in 2013, participating community health centers (CHCs) received per-member-per-month payments for empaneled Medicaid patients in lieu of standard fee-for-service Medicaid payments. With Medicaid revenue under APCM no longer tied solely to the volume of visits, the Oregon Health Authority needed a way to document the full range of care and services that CHCs were providing to their patients, including nontraditional patient encounters taking place outside of traditional face-to-face visits with a billable provider. Toward this end, program leadership defined 18 visit and nonvisit-based care activities—“Care Services That Engage Patients” (Care STEPs)—that APCM CHCs were asked to document in the electronic health record to demonstrate continued empanelment.

【 授权许可】

CC BY