Alternative Payment Calculator

Alternative Payment Calculator Purpose

The purpose of the alternative payment calculator is to identify areas where outreach may play a role in helping a health center achieve goals or provide services related to alternative payment arrangements. This calculator walks a health center user through considerations based on how health centers with integrated outreach programs viewed the role of outreach and its contribution to their supplemental or risk-based payments.

The Triple Aim includes improving patient experience, improving population health, and reducing per capita total health system costs. Public and Private Payers are increasingly using shared savings, pay-for-performance incentives, and patient-centered medical home (PCMH), and patient-centered health home (PCHH) supplemental payments to promote and reward health centers in achieving Triple Aim outcomes. This calculator is designed to help health center leaders consider how an integrated outreach program may support or contribute to achieving goals or outcomes related to alternative payment models. If the health center is not currently engaged in any such arrangements, this calculator may not be applicable.

Use the Alternative Payment Calculator if:

• Your health center receives supplemental payment for Patient-Centered Medical Home (PCMH) and/or PCHH (Section 2703).
• An outreach worker helps to deliver PCMH/PCHH services at your health center (ex: case management or care coordination).