Rhode Island Office of the Health Insurance Commissioner (OHIC)
Robert Wood Johnson Foundation, State Health Value and Strategy Program
Vermont Green Mountain Care Board
Colorado Department of Health Care Policy and Financing

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Client:

Rhode Island Office of the Health Insurance Commissioner

Challenge:

Assist OHIC with the development and implementation of revised Affordability Standards designed to strengthen the primary care sector and make health insurance more affordable.

Response:

Bailit initially conducted in–depth interviews with key stakeholders to determine the strengths and weaknesses of the original Affordability Standards. Based on those findings, Bailit worked closely with OHIC to draft revised Affordability Standards that furthered OHIC's goals as well as being responsive to emerging trends in the marketplace. Bailit is continuing to work closely with OHIC to facilitate two stakeholder advisory groups and provide technical assistance to implement the new standards.

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Client:

Robert Wood Johnson Foundation, State Health Value and Strategy Program

Challenge:

Successful dispersion of payment reform models across and within state agencies is hampered by lack of easily accessible information on specific, actionable strategies states have taken, or are considering taking, related to health care payment reform. Busy state purchasers need tailored payment reform resources.

Response:

Bailit developed and presented a series of three webinars to give state Medicaid and state employee health benefit purchaser leaders an introduction to concepts relating to reforming health care payment and the models currently being tested across the country. The series was designed to educate state officials on the current status and emerging trends in payment and delivery system reform. During the webinar series, Bailit emphasized specific, actionable strategies key to state’s successfully implementing or evaluating payment or delivery system reforms. The webinar series highlighted specific innovative states and payment reform resources for states.

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Client:

Vermont Green Mountain Care Board

Challenge:

Transform payment across public and private payers to non–fee–for–service payment models.

Response:

Bailit worked with Board staff and with work groups of payers, providers and state agency staff to support the development and implementation of an aligned Medicaid and commercial three–year ACO pilot, including the payment model, performance measures and performance standards. This was followed by work to create a single ACO statewide all–payer model, to be enabled by a federal waiver, and to design a state regulatory structure to oversee the waiver program.

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Client:

Colorado Department of Health Care Policy and Financing

Challenge:

Update payment policies for a state Medicaid program

Response:

Bailit reviewed current Colorado payment policies across an array of Medicaid vendors and providers (managed care organizations, behavioral health organizations, enhanced primary care reimbursement, federally qualified health centers, durable medical equipment, skilled nursing facilities, Program for All–Inclusive Care for the Elderly (PACE), and services for the developmentally disabled); researched strategies utilized by other Medicaid programs nationally, and made recommendations to Colorado for short and long-term updates of their payment policies.

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