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New York, Pennsylvania & Vermont lead value-based care shift — 4 states are behind the curve

The number of states and territories implementing value-based payment initiatives has grown seven-fold in five years, with New York, Pennsylvania and Vermont leading the charge, according to Change Healthcare.

Five takeaways from Change Healthcare's value-based care analysis:

1. Forty-eight states and territories — including Washington, D.C., and Puerto Rico — have implemented value-based reimbursement programs.

2. West Virginia, Indiana, Mississippi and Georgia are the only four states that have implemented few or no value-based care initiatives.

3. New York, Pennsylvania and Vermont have more actively embraced value-based initiatives, shared payment models and innovative strategies than other states:

  • New York has tested a Medicaid pay-for-performance model, risk-sharing arrangements with managed care organizations and various pilots for maternity care, HIV/AIDs and primary care.
  • Pennsylvania's efforts include multipayer episode-of-care payments for acute care, global payments for primary care and global budgeting for rural hospitals.
  • Vermont has deployed an all-payer ACO model and episode-of-care payments for Medicaid, among other initiatives.

4. Thirty-four states began implementing value-based reimbursement initiatives at least two years ago. Eight states are in the early adoption stages.

5. Twenty-three states have value-based payment targets or mandates in place.

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