Payment Rate Brief

The Payment Rate Brief was authored by Michael Bailit, president, Bailit Health Purchasing, LLC on behalf of the PCPCC. Although the PCMH is taking hold in dozens of demonstration projects across the nation, there is a wide range of payment methodologies and rate arrangements with providers within those projects. This brief provides a detailed look at the payment arrangements and dollar value of a sample of 12 PCMH initiatives that represent a diverse mix of initiatives, including those involving a single commercial payer, multiple payers and a state Medicaid agency acting alone. The brief is a reference for primary care practices and payers interested in creating new PCMH initiatives, or to refine existing ones.