Three emerging challenges for sustained payment and delivery system reform

In October 2014, the Robert Wood Johnson Foundation (RWJF) convened grantees and a diverse group of faculty to continue exploration of payment reform design and implementation issues. The grantees and national experts focused on two different topics: best practices in payment reform and new areas of payment reform development that push current boundaries. This brief summarizes three emerging challenges identified during the meeting that will need to be addressed to assure the long-term success of payment and delivery system reform:

• aligning value-based payments to providers with the compensation approaches used by providers with their employed and contracted clinicians;
• addressing social determinants of health in payment reform models; and
• strategically repurposing hospital resources in the face of declining inpatient admissions.

This brief explores each of these issues, providing examples of current activity in each area and identifying issues for future exploration and strategy development.