Health Payment Reform

Pillar Chair

Phil Boulter

About the Health Payment Reform Pillar

Our current payment system is at odds with our goals for a reformed health care system.  It fails to adequately incent or support quality and efficiency, and it ignores evidence-based practice and care coordination.  As a result, we have witnessed an erosion of primary care and wellness, a continued, yet unsustainable rate of increase in costs, a deeply fragmented system of care, and a worsening of health status indicators and levels of access. 

The Payment Reform Pillar was initiated in February 2009 to address these challenges.  We believe that the stakeholders in New Hampshire are uniquely positioned to design and implement a payment system that values, prescribes and rewards medical care that is tightly coordinated and of superior quality and efficiency. We believe our ability to affect change is unique as we represent private and public payers, clinicians, delivery systems, state government and private citizens, and we have established positive precedents for advancing policy and programs through our work for and as the NH Citizens Health Initiative.

We will re-architect the payment system in New Hampshire to:

• Align payment, goals and incentives across the systems of care: primary, specialty,
  behavioral, ancillary and hospital;
• Align goals and incentives across employers, payers and systems of care;
• Address the unsustainable rate of growth in healthcare expenditures;
• Reward explicitly defined quality care;
• Reward excellence in the delivery of evidence-based clinical practices;
• Incent the use health information technology;
• Recognize administrative best practices and lean processes; and
• Serve as a model of transparency. 

We will achieve this by taking active and immediate steps through transparent collaboration among a diverse group of stakeholders.  We will evaluate a full breadth of payment reform schemes and design pilots that leverage those attributes that best address the Pillar goals and the New Hampshire clinical, public health, market and policy nuances.

For more information on this working group contact Heather Staples