1. Interrelation of Organization and Payment
Integrated system capitation
Global DRG fee: hospital, post- acute, and physician inpatient
Global DRG fee: hospital only
Global ambulatory care fees
Global primary care fees
Blended FFS and medical home fees
FFS and DRGs
Outcome measures; large % of total payment
Less Feasible
Care coordination and intermediate outcome measures; moderate % of total payment
Continuum of Payment Bundling
Continuum of P4P Design
More Feasible
Preventive care; management of chronic conditions measures; small % of total payment
Small MD practice; unrelated hospitals
Primary care MD group practice
Multi-specialty MD group practice
Hospital system
Integrated delivery system
Source: A. Shih, K. Davis, S. Schoenbaum, A. Gauthier, R. Nuzum, and D. McCarthy, Organizing the U.S. Health Care Delivery System for High Performance (New York: The Commonwealth Fund, Aug. 2008).