Webinar Resources
Description: As the District of Columbia and its Medicaid Managed Care Plans continue to build toward an integrated health system that delivers whole-person care
Description: This webinar explores the critical connection between the cost of healthcare ...
Description: It is important for healthcare providers to understand the cost of the services ...
Description: With the District of Columbia’s movement to a reimbursement system ...
Practice leaders face more decisions than ever as the District of Columbia works to build an integrated health system that delivers whole person care. This learning series is designed to help organizational decision makers better manage change within a dynamic health system. Part 1 will introduce ways that leadership can transform ingrained policies and practices using new information, data points, and approaches to improve care access and outcomes. The session will also preview exciting next steps for the learning series moving into 2024.
Measuring the cost of providing services is critical for making informed business decisions. With the updated District of Columbia Medicaid Fee Schedule moving reimbursement of procedure codes for key behavioral health services from a per-occurrence basis to codes allowing reimbursement based on the amount of time spent providing these services, health care leadership must understand the costs that directly and indirectly support service delivery. This learning session will provide key decision makers, financial analysts, and practice management staff with an understanding of how to determine cost of care and how to compare cost of care with reimbursement rates to inform decision making.
In the dynamic landscape of healthcare, crafting a compelling value proposition involves a strategic blend of audience understanding, innovation, and responsiveness to the needs of payers, community partners and other stakeholders. This short take describes the steps to creating a strong value proposition.
The transition to Value-Based Payment (VBP) represents a multifaceted process, encompassing significant system-level adjustments in healthcare delivery and reimbursement. Effectively implementing these changes requires a methodical and developmental approach. To facilitate this transition, a comprehensive toolkit has been designed, empowering healthcare providers to evaluate their existing readiness and access resources essential for enhancing their capabilities to operate within a value-based payment framework. In this webinar, we will introduce providers to this invaluable toolkit and guide them on how to navigate it seamlessly.
Transitioning to payment models that support value-based care means doing business differently. Many District healthcare providers are requesting assistance preparing for and implementing this important change. This virtual learning collaborative focused on legal agreements, contracting, and financial topics, including revenue cycle management and assessing risk. Presenters shared scenarios, assessments, and tools to advance capacity and understanding.
This short take video will outline the elements of shared savings contract and where the “share” fits in. It will outline some of the key considerations to think about when trying to negotiate your share of savings with a payer for a value-based contract (including downside risk v. upside potential, contract structure, and other value-based care funding), as well as touch on internal considerations for providers when negotiating a share of savings (i.e. is the share enough to cover the provider’s investment to perform in the contract).
Value-Based Payment (VBP) arrangements with MCOs are generally described in a separate exhibit to a provider's managed care contract. This session will help participants assess the opportunities and risks of participating in VBP arrangements by evaluating legal terms associated with pay-for-performance programs, total cost of care programs, and capitation payment arrangements. Finally, the session will offer participants practice pointers for evaluating contract terms and examples of favorable and unfavorable VBP contract terms.
VBP comes with lots of new vocabulary (and a deluge of new acronyms - including "VBP"). Come learn some of the key words, concepts, and constructs with which to understand VBP.
Different states (and the Health Care Payment Learning and Action Network) define different types of value-based contracts in different ways. Gain an understanding of the different types of VBPs and the path to them.
Studies have shown that $1 invested in integrating primary and behavioral healthcare will yield $4.50 in savings…and clients and providers both like integrated care better. Learn about the promises and pitfalls of primary and behavioral health integration.
One of the core concepts for VBP is attribution. Come learn about this critical component of the contracting process.
One of the core concepts for VBP is attribution. Come learn about this critical component of the contracting process.
CMS has signaled its intent to move from strict fee-for-service reimbursement to value-based payment for Medicaid as it has been actively doing for Medicare over the past decade. A few FQHCs are pursuing advanced alternative payment models on their own but most are choosing to clinically integrate with others, especially other FQHCs. This session will share national experiences from these initiatives and provide a framework for evaluating strategic options for DC FQHCs to progress in their pursuit of advanced alternative payment models.
Medicare, state Medicaid agencies, managed care organizations, and commercial insurers are increasingly adopting value-based payment (VBP) models. Community Health Centers (CHCs) are uniquely positioned to deliver on that high expectation by offering enhanced access to high quality primary care, coordinating the care delivered by specialists, hospitals and other institutions and care managing the most complex individuals. This requires CHCs to transform their care delivery to efficiently deliver optimal patient- and population-level health outcomes and successfully manage costs. Many CHCs are forming clinically integrated Networks to create contracting leverage, make joint investments in data analytics and collaborate to develop complex care management and clinical models of care.
Description: Community-based providers often possess competitive advantages over ...
Description: Basic overview of legal requirements for DC's Medicaid MCOs and how ...
Description: RAG is a tool designed to assess the viability of expectations related ...
Description: Value-based payment reimbursement links payment to the quality and ...
High-need, high-cost (HNHC) patients often face multiple challenges including high disease burden, behavioral health comorbidity, functional limitations and social barriers to treatment plan compliance. They typically make up just 5 percent of the population, but account for 50 percent of health care costs. This webinar will discuss taking a tailored approach to care in order to improve their outcomes.
One of the greatest threats to success for clinically integrated networks is an uneven commitment from disparate providers to improve patient outcomes and reduce avoidable, low-value healthcare costs. Success depends on providers investing time and other resources to achieve performance targets. Although the distribution of value-based payments should certainly take into consideration the number of patients either attributed or served, it must also recognize the contribution each entity made to generate the incentive payments. This webinar will explore principles and examples of distribution methodologies aimed at fairly allocating those dollars.
Integrated Care DC is managed by the DC Department of Health Care Finance (DHCF) in partnership with the DC Department of Behavioral Health (DBH). This project is supported by the U.S. Department of Health and Human Services (HHS). A total of $4,598,756, or 74 percent, of the project is financed with federal funds, and 1,639,167, or 26 percent, is funded by non-federal sources. The contents are those of the author(s) and do not necessarily represent the official views of, or an endorsement by, HHS or the U.S. Government.