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Health pilot eyes a new approach to reimbursement

New Hampshire Business Review, August 2, 2010

Pay-for-performance may be coming to New Hampshire’s healthcare industry. Under a five-year pilot program unveiled earlier in July by Gov.John Lynch, healthcare providers will be compensated based on their quality of care instead of the current fee-for-service model. Five working groups that include over a dozen hospitals and other healthcare providers around the state have agreed to take part in the “accountable care organization,” or ACO, program. The pilot will use healthcare benchmarks that providers must meet in order to receive reimbursement, but just what those benchmarks are and how providers will be compensated have yet to be determined. What is known is that “they will define the long-term plan and the overall transparency,” said Heather Staples of the New Hampshire Citizens Initiative and the pilot’s facilitator. “We will probably be looking at typical measures – cardiac care and readmission rates, for example – as well as youth and preventative measures.”