Transfer of Payment and Delivery System Innovations from Abroad to the United States, Phase 1


Faced with the challenge of providing good-quality, integrated, and efficient care to high-need, high-cost patients, many countries besides the United States are experimenting with accountable care models. Through previous research supported by The Commonwealth Fund, Mark McClellan, M.D., and his group have developed a framework for comparing and translating for the U.S. context international accountable care innovations that leverage health care financing to achieve better health system performance. Building on that work, this multiphase project will engage providers, payers, employers, policymakers, and other stakeholders in accelerating U.S. adoption of successful payment and care delivery innovations from abroad that align with local, state, and national payment reforms that are moving the U.S. toward more accountable care. In phase 1 of this project, McClellan and his team will: a) identify and engage potential implementation sites and stakeholders, including payers and regulators, in codeveloping a model for transferring international accountable care innovations to the U.S.; b) using a "client-centered" approach, define the problems in the U.S. care delivery system that must be addressed; c) establish a network of experienced implementation partners, including the Institute for Healthcare Improvement (IHI); and d) define what success would look like. If this work proceeds satisfactorily, phase 2 support will be requested to undertake a global scan for effective approaches to caring for high-need, high-cost patients and payment mechanisms that drive better quality and lower costs. Phase 3 activities would center on analyzing and modeling of the impact of these innovations, while phase 4 would pilot a set of innovations in a U.S. health system or community. This project will engage providers, policymakers, payers, and regulators in supporting the U.S. uptake of successful accountable care innovations from abroad that can improve care for high-need, high-cost populations.

Grant Details

Grantee Organization:
Duke University
Principal Investigator:
Mark McClellan, M.D., Ph.D., M.P.A., and Krishna Udayakumar, M.D., M.B.A.
Award Amount:
Approval Date:
April 11, 2017

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