title: How alternative payment models in emergency medicine can benefit physicians, payers, and patients.
abstract: While there has been considerable effort devoted to developing alternative payment models (APMs) for primary care physicians and for episodes of care beginning with inpatient admissions, there has been relatively little attention by payers to developing APMs for specialty ambulatory care, and no efforts to develop APMs that explicitly focus on emergency care. In order to ensure that emergency care is appropriately integrated and valued in future payment models, emergency physicians (EPs) must engage with the stakeholders within the broader health care system. In this article, we describe a framework for the development of APMs for emergency medicine and present four examples of APMs that may be applicable in emergency medicine. A better understanding of how APMs can work in emergency medicine will help EPs develop new APMs that improve the cost and quality of care, and leverage the value that emergency care brings to the system.
authors.affiliation: Dept. of Emergency Medicine and Robert Wood Johnson Foundation Clinical Scholars Program, Yale University, New Haven, CT, United States. Electronic address: nharish@penbayhealthcare.org.
authors.forename: Nir J
authors.initials: NJ
authors.lastname: Harish
authors.affiliation: Center for Healthcare Quality and Payment Reform, Pittsburgh, PA, United States.
authors.forename: Harold D
authors.initials: HD
authors.lastname: Miller
authors.affiliation: Dept. of Emergency Medicine, George Washington University, Washington, DC, United States.
authors.forename: Jesse M
authors.initials: JM
authors.lastname: Pines
authors.affiliation: Dept. of Emergency Medicine, University of Colorado, Aurora, CO, United States.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Zane
authors.affiliation: Dept. of Emergency Medicine, University of Colorado, Aurora, CO, United States.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Wiler
mesh_terms: D004635:Emergency Medicine / Q000191:economics*; D005102:Health Expenditures / Q000639:trends*; D006291:Health Policy / Q000639:trends*; D006801:Humans; D014481:United States
keywords: Alternative payment model; Health policy; Reimbursement