(a) The commission shall establish payment initiatives to test the effectiveness of quality-based payment systems, alternative payment methodologies, and high-quality, cost-effective health care delivery models that provide incentives to physicians and other health care providers to develop health care interventions for enrollees or recipients that will:
(1) improve the quality of health care provided to the enrollees or recipients;
(2) reduce potentially preventable events;
(3) promote prevention and wellness;
(4) increase the use of evidence-based best practices;
(5) increase appropriate physician and other health care provider collaboration;
(6) contain costs; and
(7) improve integration of acute care services and long-term services and supports, including discharge planning from acute care services to community-based long-term services and supports.
(b) The commission shall:
(1) establish a process through which a physician, other health care provider, or managed care organization may submit a proposal for a payment initiative; and
(2) determine whether implementing one or more proposed payment initiatives is feasible and cost-effective.

(c) If the commission determines that implementing one or more payment initiatives is feasible and cost-effective for this state, the commission shall establish one or more payment initiatives as provided by this subchapter.

Text of section effective on April 01, 2025