Lessons for Specialty Care Payment Reforms: Insights from Maryland’s GBR Model

By Danélia Botes

July 7, 2023

 Maryland’s GBR model has been hailed as a game-changer in tackling the rising costs of healthcare. However, it’s crucial to recognize that payment reforms can have varying effects across different types of care. Here are some key takeaways for CMS’s new value-based specialty care strategy.

1️⃣ Tailored Payment Models: Specialty care savings may require specific payment models for different types of care, like cancer surgery. It’s essential to design reforms that cater to the unique needs of each specialty.

2️⃣ Nuanced Quality Measures: Quality assessment in specialty care should go beyond traditional metrics like readmissions and emergency visits. Patient-reported outcomes and person-centered measures should play a more significant role in evaluating care quality.

3️⃣ Health Equity Considerations: Specialty care reforms must address health equity. By separating reimbursement from volume, vulnerable populations can benefit from sustainable financing. The Global Equity Model offers a framework to assess the success of payment reforms based on health outcomes.

4️⃣ Policy Innovation: Replicating the success of Maryland’s GBR model requires policy innovation and alignment. Other states may need to establish cost growth targets or overcome implementation challenges to ensure viability.

5️⃣ Integration of Primary and Specialty Care: Meaningful delivery system changes are crucial to advancing the integration of primary and specialty care. Global budgets provide a foundation for reorganizing how specialty care is delivered and reimbursed.

There is much to learn from Maryland’s experience and drive effective payment reforms in specialty care. 

 

 

 

Reference url

Recent Posts

South African National Health Insurance Bill
          

High Court on South African National Health Insurance Bill

📢Latest update on the NHI! 📢 Dive into our latest piece on the judicial review of the South African National Health Insurance Bill. Learn about the intriguing case and its implications on the healthcare industry. 🏛️💼💡 #HealthcarePolicy #LegalReview #NationalHealthInsuranceBill

Global Perspective on Orphan Medicines
                

A Global Perspective on Orphan Medicines and Rare Diseases

Discover the global perspective on orphan medicines and their role in treating rare diseases. Learn about the unique challenges and incentives in their development. 🌍💊 #OrphanMedicines #RareDiseases #HealthcareInnovation #RareDiseaseDay. Read more here

            

The Impact of Universal Health Coverage on Poverty Reduction in Low and Middle-Income Countries

📚 New research findings alert! 🚨 A recent study shows that increasing coverage of maternal, child and inpatient services is associated with reduced poverty in low and middle-income countries. 💡 This supports pro-poor approaches towards Universal Health Coverage. 🌍 Let’s work together to ensure #HealthForAll and #EndPoverty. Read more here 📖 #UHC #GlobalHealth #HealthEquity

When you partner with Syenza, it’s like a Nuclear Fusion.

Our expertise are combined with yours, and we contribute clinical expertise and advanced degrees in health policy, health economics, systems analysis, public finance, business, and project management. You’ll also feel our high-impact global and local perspectives with cultural intelligence.

SPEAK WITH US

CORRESPONDENCE ADDRESS

1950 W. Corporate Way, Suite 95478
Anaheim, CA 92801, USA

JOIN NEWSLETTER




SERVICES

© 2024 Syenza™. All rights reserved.