Robert Wood Johnson Foundation Payment Reform Evaluation Project Development and Implementation of Payment Reform to Pay Equally for What Works Equally Well Institute for Clinical and Economic Review, Massachusetts General Hospital

Introduction This report summarizes the history of an innovative payment reform project in Massachusetts which began in 2009 and ended in autumn 2011, at which time project stakeholders mutually decided that the originally anticipated payment change -paying equally for procedures that, according to comparative effectiveness reviews, produced equal outcomes for patients with low-risk prostate cancer – was not feasible. This report describes the context of the original payment reform project; its objectives and implementation approach; the logic model underlying its design; the barriers and facilitators to implementation; evaluation; and lessons learned. In addition to reporting on the original project, we present changes in the Massachusetts environment through autumn 2012, the subsequent evolution of payment and health care innovation of the project and in Massachusetts, and updated lessons for payment reform endeavors.