What does VBP really mean for BH providers (beyond P4P)? How do you get to an advanced APM as a BH provider?

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.

Value-based payment reimbursement links payment to the quality and effectiveness of the care we deliver. This webinar considers the clinical strategies used to achieve valuable outcomes and demonstrates that the care delivered is effective, including care management, integrated/whole-person care, and measurement-based care.

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. This webinar will explore that national trend and how it may apply to District of Columbia CHCs.

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.

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.

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.

View Resource The previously recorded webinar and associated materials are available in the resource library. Transitioning to payment models that support value-based care means doing business differently. Many District healthcare […]