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Aligning Delivery and Payment Reform for Maximum Impact

As one looks at the efforts to transform health care delivery and payment in Colorado, two overwhelming impressions emerge. The first is the sheer quantity of innovation underway in our state. To see what I mean, look at CIVHC’s Inventory of Payment Reform and Delivery Redesign Strategies and the graphic that accompanies it . While we’ve done our best to be comprehensive, we know we’ve left important initiatives off these documents (and please contact us if yours is missing). But even our non-exhaustive list requires nearly two dozen pages to describe.

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A Solid Foundation Helps Meet a Health Data Challenge

Developing an information resource as complex as the Colorado All Payer Claims Database is a difficult and challenging undertaking. Although sophisticated technology is available, creating a functional database from complex claims information submitted by multiple payers and spanning several years is no easy task. The reality is that even the large and well established health payers face challenges in synthesizing and making sense of their own claims data.

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Three Tsunamis are Driving Disruptive Innovation

There is broad consensus from stakeholders that our current dysfunctional system needs to change dramatically to reach the Triple Aim objectives of better health, better care and lower costs. Making the transformation happen is the difficult part. At CIVHC, we find it useful to remind stakeholders across Colorado that efforts need to be informed by three “tsunamis of change” which we believe will alter the landscape of health care over the next decade. 

  1. Financial Instability. We are on a fiscal cliff. As a country, we are out of money and the majority of our public health care costs are being financed through debt. It’s unsustainable and we are kidding ourselves to think that we will continue to push off the hard choices in health care or other areas paid for by government.
     

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