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RWJF 2010 Payment CFP-Inactive

RWJF 2010 Payment CFP-Inactive

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Published by Michael Painter
2010 RWJF Payment Reform CFP
2010 RWJF Payment Reform CFP

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Categories:Topics, Art & Design
Published by: Michael Painter on Jul 12, 2011
Copyright:Attribution Non-commercial


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Health care in America is uneven and oten o poor quality even though we spend moreon care than any other nation. The way we pay or care is a major underlying, contributingcause o this poor health care quality and value. Generally, our current payment systemsprovide powerul incentives or delivering more services to more people. Paying or morecare rather than better care, in turn, uels the growth in health care costs but does notnecessarily promote higher quality or value. Current payment schemes also too oteninhibit eorts to improve care. Ultimately, payment methods must change in ways thatreward high value rather than high volume.In order to drive high-value care, payment methods must reward, promote and sustainimprovements in the quality and cost o care. At the same time, although improvedpayment systems hold signifcant promise or improving the value o health care,undamental payment reorms are inherently complicated and risky. Their success dependson many interconnected pieces o the market and multiple interested stakeholders. Thereare also multiple interconnected opportunities or ailure. Nevertheless, value-enhancingpayment methods are necessary or high-value care.The recently enacted Patient Protection and Aordable Care Act includes a variety o provisions aimed at stimulating payment and delivery system reorms, precisely or thesereasons. Those new ederal payment experiments will unold over the next several years.These payment eorts will ocus primarily on Medicare and to a certain extent Medicaid.The Robert Wood Johnson Foundation (RWJF) is hoping to stimulate locally-based,complementary, payment experimentation with this solicitation and related oerings.Payment changes likely depend undamentally on aspects o a given health care marketlike: better and widely shared perormance inormation, consumer and purchaser ability todemand high quality, and resources that support improvements in care. At the same time,although improved payment systems hold signifcant promise or improving the quality,cost and value o health care, there are a number o important issues and questions thatneed to be addressed and a variety o challenges that need to be overcome beore anyonecan credibly reorm payment.
RWJF seeks to und innovative proposals or payment reorm eorts designed to promotehigh-value health care outcomes that leverage existing market knowledge, partnerships andresources. These unds will not support extensions o existing pay-or-perormance (P4P)eorts or implementation o generic medical home demonstrations. We would, however,consider unding or P4P eorts or medical home demonstrations that are linked with
perormance payments. For example, a payment incentive program based onreducing hospital readmission rates or chronic disease patients might be an appropriateplace to start or a given group or community and could be built around a P4P or medicalhome eort.Applicants may propose a multistakeholder payment strategy or a payment reormexperiment that pertains to a limited care dyad or triad o, or instance, health plan,employer and health care provider. Payment reorm experiments and strategies arecomplicated and challenging; nevertheless, applicants should be as bold as possible in
Payment Reform for High-Value Care
2010 Call for ProposalsBrief Proposal Deadline
October 20, 2010
Key Dates and Deadlines
October 20, 2010 (3 p.m. ET)
Deadline or receipt o brie proposals.
Early December 2010
 Applicants notifed i invited to submita ull proposal.
February 2, 2011 (3 p.m. ET)
Deadline or receipt o ull proposals.
Inquiries may be directed to
©2010 Robert Wood Johnson Foundation • Quality/Equality • September 2010
For more inormation about unding opportunitiesrom the Robert Wood Johnson Foundation visit
Sign up to receive e-mail alerts on upcoming
calls or proposals at
the proposed payment reorm activity. Proposals and strategies that highlight creative,pragmatic, opportunistic approaches will be stronger proposals than those that do not.In developing and describing their payment reorm activities or market payment reormstrategies, applicants should ensure that the activity or strategy explicitly describes therespective payers who will participate and how they will participate. I invited to submita fnal proposal, applicants must include written statements o commitment rom thoserelevant payers.Successul projects will describe:a.
Existing activities.
Describe the kinds o payment reorm planned or already started.These activities might include local payment summits; payment pilots sponsored byhealth plans, health systems or others; and participation in state-wide or larger eorts.b.
Proposed activities.
Indicate whether applicant will either: a) plan and develop a newpayment reorm strategy, i none now exists; or b) plan, execute or build substantially onexisting payment eorts.c.
Important aspects of proposed payment plan or implementation activities.
Describe the ollowing:
Project Focus
Describe the condition or procedure or set o conditions and procedures that will
be the ocus o the payment reorm eort.Describe the desired actual types or range o cost and quality outcomes and the
types or range o payment reorm activities that need to happen in order to achievethose outcomes.Detail how the project will document the impacts o the eort on both cost and
quality preerably in a value calculation to improve quality and lower or managecosts, gain experience with care improvements that support payment changes, anddevelop and test administration systems.Link strategy with other relevant eorts including, or instance, ederally-unded or 
state-unded payment reorm eorts, as appropriate or possible.Incorporate relevant measures o costs, quality, implementation costs and
unintended consequences.
Market and Commitments
I invited or a ull proposal, include an explicit written commitment rom the
participating payers that will be involved in the payment reorm strategy.Approximate the portion o total market health care expenditures impacted by the
targeted health care conditions.Approximate the number o physicians or other health proessionals involved
in the payment project.
Describe the signifcant technical and other barriers to the suggested payment
strategy and how that payment work might overcome these kinds o barriers.
©2010 Robert Wood Johnson Foundation • Quality/Equality • September 2010
©2010 Robert Wood Johnson Foundation • Quality/Equality • September 2010
Work toward real-world testing to generate practical business models, in addition to
potential peer-reviewed scientifc tests.Indicate commitment to help inorm or assist other related payment reorm projects
and to participate in a ormal evaluation o this payment eort.
Timelines and Deliverables
Include a timeline or key activities, milestones and important deliverables.
Specifcally note whether deliverables will likely include piloting o new payment
models during this grant period.
Total Awards
A maximum o three grants o between $50,000 and $300,000 each will be awarded or 
up to 36 months each.Up to $300,000 in total will be awarded in this solicitation.
Eligibility Criteria
Applicants must be based in the United States or its territories and may be either public
entities or nonproft organizations that are tax-exempt under Section 501(c)(3) o theInternal Revenue Code.
Selection Criteria
Proposals will be selected on the basis o the ollowing:Fit with the topics described in this solicitation.
Eorts that make unique contributions to learning about implementing payment reorms
that support high-value care.Feasibility including evidence o commitment rom payers and other relevant stakeholders.
Scope and potential impact o the payment project.
Use of Grant Funds
Grant unds may be used or project sta salaries, consultant ees, data collection and analysis,meetings, supplies, project-related travel, and other direct project expenses, including a limitedamount o equipment essential to the project. In keeping with RWJF policy, grant undsmay not be used to subsidize individuals or the costs o their health care, to support clinicaltrials o unapproved drugs or devices, to construct or renovate acilities, or lobbying, or as asubstitute or unds currently being used to support similar activities.
RWJF will support an independent research team to evaluate these payment projects. As acondition o accepting RWJF unds, grantees must participate in the evaluation. Granteeparticipation includes assisting with necessary data collection to accomplish the evaluationobjectives. These data collection eorts may include interviews with key stakeholders, phoneor mail surveys, document collection and analysis and participation in key meetings.

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