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Transforming Healthcare Financing for Accountable Care: Bridging Gaps and Incentivizing Value

Addressing funding and financing for Accountable Care begins with understanding the population and current providers like FQHCs, hospitals, and private practitioners. Reorganizing delivery systems, enhancing high-value care, and addressing gaps in capacity are crucial. Despite models like FQHCs, the safety net population is underserved. Community hospitals face challenges, and private physicians are underrepresented. Initiating Accountable Care in a Medi-Cal supported environment requires reorganization and transparency. Incentives, investment in infrastructure, and integration are key to reallocating resources for better care delivery.

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Transforming Healthcare Financing for Accountable Care: Bridging Gaps and Incentivizing Value

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  1. Addressing the funding and financing of Accountable Care does not start with money. • Begin with the population • Consider the current providers • Public Systems • Federally Qualified Health Centers • Private Practitioners including hospitals • Identify gaps in capacity • Reorganize into a delivery system • Design financing to enhance and incentivize high value care.

  2. Counties and Subspecialty Care

  3. FQHCs are models but care for only 14% of the safety net population

  4. Community hospitals are fragile and not nimble.

  5. Community based care lives on the margin

  6. No one represents private physicians

  7. Can Accountable Care come about in a Medi-Cal supported environment? • “More important now than ever.” • Reductions and reorganization will happen • Rates • CCS • SPD • FQHC financing • Payment to Health plans • Consolidation of programs

  8. Before incentives • Transparency and information • Investment in infrastructure and start up • Representation of physicians • Decreasing in creaming off the top • Health plans 6-8% • IPAs 10-12% • Community benefit reallocated to needy populations • Consolidation and integration (eg. MH/BH/PC)

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