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  1. 1

    Stephen Borness

    Excellent suggestions, same business case approach could apply to QI initiatives ? And the resulting protocols (clinical or not) coded as interventions

  2. 2


    Can a state really “try” this, without baking it into their on-going funding recipe?

    This article talks about developing business cases between Cmwlth & states (with all states agreeing on additions to IHPA general list items?) within the existing boundaries of the ABF architecture.

    This is where I see a problem – I’m not sure all states (particularly those with small tax bases) want to further propagate their ABF relationship with the Cmwlth, particularly by defining ‘service events’ for non-episodic services, in order to enlarge their service profiles … and especially not while IHPA had been investigating bundled payment options.

    Is it possible that states (let’s be honest.. treasury, rather than the health department readers of Croaky) are actually looking at this, but instead see greater value in resisting ABF and lobbying for some sort of specific purpose or other equalized payment (block funding)?

    My point is that perhaps the the risk could be re-framed – it’s not that individual states fear they won’t get a fair share of ABF funding, but that instead, greater ABF funding isn’t fair for all states.

    So rather than the “dead-end discourse” described, is it instead a sensible policy posture?

    Not saying this posture is right (or that it even exists), but as always – there are greater (or at least differing) perspectives on these things. Rarely is is actually “black and white”, as suggested.

    Granted this is hard to profile in a short memo, but rather than simply selling one “should” solution, it’d be helpful to promote some greater understanding of the policy options so that readers can form informed opinions, rather than regurgitate those of others.


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