Welcome to our inaugural issue of Improving Incentives. The intent of this publication is to periodically share lessons we’re learning from field implementations, in an effort to help others who are implementing payment reform programs. I continue to be struck that the key to success in most of our endeavors is operational effectiveness. Our first article underscores this point. Episode of care payment has mainly failed to take off because of the challenges plans face when implementing it operationally. That problem is in the process of being solved permanently. Similarly, BCBS of LA has picked up on the operational simplicity of implementing the Bridges to Excellence programs as a way to reward physicians in Louisiana who can demonstrate they are delivering good care to patients with diabetes or cardiac disease. And thanks to our collaboration with the ABIM and other intermediaries, reporting of clinical data by physicians is becoming a lot easier, and physicians across the country (and their patients) are benefiting from that reporting by instituting clinical process improvements. Finally our newly launched Implementation Toolkit is a guide for how to operationalize an episode of care payment program, such as the PROMETHEUS model. We hope these case studies and examples will help you in your work, and we welcome suggestions and feedback.

Francois de Brantes Executive Director Health Care Incentives Improvement Institute, Inc. francois.debrantes@hci3.org