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Yesterday Bob Berenson of the Urban Institute graciously walked dozens of webinar participants through the pros and cons of the main payment reform options – fee-for-service, capitation/population-based payment, shared savings and bundles/episodes – and the key challenges of each. Several CT plans are now considering implementing shared savings models, including Medicaid. The main takeaways, from both the webinar and the questions from CT stakeholders, were:

·                         Everyone agrees on the concept of value-based purchasing, but there is no consensus on “value” or how to measure it
·                        There is a great deal of diversity in each model
·                        No single model is perfect, enlightened systems are moving to a merged model using multiple levers to address the drawbacks in each model
·                        Medicaid is different – underpayment and other features raise the risk of underservice and reduce incentives for overtreatment
Click here for a videoof the webinar and here for slides.