In the face of rising health care costs, Pennsylvania aims to accelerate the shift from volume to value-based payment models. The current status of payment in Pennsylvania is a mix of Category 2 (fee for service with a link to quality & value) and Category 3 (APMs built on fee-for-service architecture). Pennsylvania will join federal efforts in establishing a four-year goal to shift the payment mechanisms across the commonwealth to ones that reward positive, sustainable outcomes versus ones that incent higher patient volume. The final targets will be set in late 2016 based on research currently being conducted by Catalyst for Payment Reform, a non-profit think tank devoted to accelerating the adoption of value-based payment mechanisms. To achieve this goal, Pennsylvania’s value-based payment strategy will include both population-based payment models and episode-based payment models, that is, shift payment methodologies to Categories 3 & 4.
Pennsylvania Department of Health