There were reports that the TCOC
was launched by the Naxals early this year, from late February as compared to March-end, the official said.
Shared savings incentive models typically blend prospective FFS with sharing of retrospective, TCOC savings between payer and provider organization.
Given the greater power of a loss compared to a gain of equal magnitude (Kahneman and Tversky 1979), payers could achieve the greatest incentive effect by setting provider share of losses (deficits against the TCOC target) somewhat lower than the provider share of gains (TCOC savings).
The greatest potential challenges to payers in shared savings models are the twin requirements to choose a level of TCOC budget per insured member per month (PMPM) that offers strong incentives for total savings, and to craft a valid and reliable method of attributing patients to the providers accepting payment based on shared savings.
P4P incentives and shared savings (based on TCOC) can be deployed to offset some limitations of FFS as a general method for inducing value improvement.
The TCoC Phase II teams, led by NRHI, will also develop strategies and actionable steps to educate and engage employers interested in reducing the costs of providing healthcare coverage for their employees.
Participation in the TCoC Phase II project allows CIVHC and the other partnering organizations to further develop their cost of care reports, use longitudinal data to evaluate trends over time, examine the impact of alternative risk adjustment and attribution methods, and continue working toward standardization of measures across regions.
For more information about CIVHC's work in Phase I of the TCoC project, go to: http://www.civhc.org/Voices-On-Value/May-2015/Comparative-Performance-Data-for-Physicians-An-Imp.aspx/
In another MSEL scenario, five soldiers listed as missing-in-action drove a white pickup truck by the TCOC area and sprayed an unidentified agent into the air.
In this case, the nighttime chemical attack against the TCOC forced them to displace and go through decontamination procedures, CW Sugai said, who observed how well they did.