Description: This resource provides strategies for cultivating a strong relationship with a Managed Care Organization (MCO) when entering into a value-based purchasing agreement. It provides insights into what the payer values and pinpoints measurable outcomes that...
Description: This resource assists providers in understanding the transition from value-based arrangements, which were previously constructed solely on the achievement of quality metrics, to models now grounded in the total cost of care. It furnishes providers with a...
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.
https://integratedcare.dc.gov/wp-content/uploads/2023/09/Managing-Expectations-Related-to-Behavioral-Health-Carve-In.mp4 Description: Basic overview of legal requirements for DC’s Medicaid MCOs and how these requirements intersect with behavioral health...
https://integratedcare.dc.gov/wp-content/uploads/2023/09/RAG-Tool-for-Quality-Measures-and-Contracts.mp4 Description: RAG is a tool designed to assess the viability of expectations related to quality metrics and reporting requirements providers may encounter in...
https://integratedcare.dc.gov/wp-content/uploads/2023/09/Clinical-and-Programmatic-Implications-of-VBP-.mp4 Description: Value-based payment reimbursement links payment to the quality and effectiveness of care we deliver. This webinar considers the clinical...
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.
https://integratedcare.dc.gov/wp-content/uploads/2023/09/Getting-to-an-Advanced-APM-as-a-BH-Provider-–-Behavioral-Health-VBP-Part-3.mp4 Description: What does VBP really mean for BH providers (beyond P4P). How do you get to an advanced APM as a BH provider?...
