Webinar Resources
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.
Description: What does VBP really mean for BH providers (beyond P4P). How do you ...
Description: Once health care providers have demonstrated the ability to reach ...
Review of DC's Medicaid MCO contract requirements related to equity and value-based purchasing and tips on how to use these requirements to your clinic or organization's advantage.
Advances in digital technologies and data analytics have created unparalleled opportunities to assess health data accelerating the ability of science to understand and contribute to improved health behavior and health outcomes. Additionally, behavioral health in the United States is being challenged to address persistent health inequities while improving the quality and value of the care delivered. As regulators, payors, and policies push behavioral health toward data-driven performance, the pressure for behavioral health providers to measure and monitor outcomes increases. This training will introduce providers to the key facets of using data to drive performance including metric selection, diagnosing performance issues and acting on data, driving innovation, and making data analytics a central part of the behavioral health quality strategy.
This session will provide an orientation to quality initiatives implemented by MCOs in their managed care contracts. The session will explain the importance of these quality initiatives, the associated performance measurement reporting, and the contract terms that implement those quality initiatives. In addition, participants will be introduced to the VBP pathway so that regardless of current state of readiness, participants can understand the expectations of quality and be prepared to meaningfully assess these expectations in a VBP contract.
Description: The use of measurement-based care (MBC) centers on the use of regular ...
A basic overview of the structure and function of Accountable Care Organizations (ACO) as well as an exploration of their challenges and opportunities in advancing value based care contracts with the government and private payers.
This webinar will focus on the “why” of transitioning from fee-for-service to capitation to pay for community health center direct services. Dr. Jones will discuss how fee-for-service reimbursement limits patient access to care and hampers efforts to improve patient self-management and accountability for their own health. He will share examples of how innovators are using lessons learned from other service industries to disrupt the health care market. Participants will learn how moving away from the fee-for-service system can preserve revenue streams but also support new models of care, and how payment reform can help to address primary care workforce shortages.
Managed care contracts, like many legal contracts, are challenging to understand. This session will provide a roadmap to key terms commonly found in managed care contracts. The session will explain what these terms mean in plain language and offer examples of favorable and unfavorable terms. In addition, the session will offer pointers for evaluating the favorability of contract terms and describe potential changes to standard terms that participants may wish to address during negotiations.
Value is a function of impact and cost. BH providers provide a very high-impact, relatively low-cost service. As such, payment methodologies that reward value should be an opportunity for them to increase their revenue. But that's a theory that only plays out in practice sometimes. Come learn what BH providers need to do to be successful in a value-based environment.
An introduction to the basic concepts, structures, models, and mechanics of value-based payments.
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.
This is a self-assessment tool intended to help healthcare providers plan for negotiations around proposed managed care contracts. The tool can be used for internal conversations to analyze key terms, develop strategic direction, and set priorities for approaching negotiations. This tool can help providers determine if they are ready to contract, what level of risk they can tolerate, and what areas to focus on in negotiations.
PCBH services not only facilitate change at the individual level but impact the family system. Conversely, family engagement in PCBH services can expedite the achievement and sustainability of an individual’s health goals. Strategies will be discussed that can help enhance family engagement within the PCBH model of care.
Description: Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ+) ...
View materials from this event hosted by Department of Health Care Finance, DBH Training Institute, & Integrated Care DC on May 9, 2023. The in-person workshop was designed for behavioral health providers and other organizations seeking to prepare for the integration of behavioral health into the District’s Medicaid Managed Care Program. Presenters shared information and facilitated exercises to help leadership, clinical and operational staff, and other stakeholders develop the organizational competencies needed to succeed in managed care, including an understanding of managed care principles, how to communicate effectively with managed care partners, and how to effectively demonstrate the value of care through quality measurement and population health.
The diagnosis of a long-term health condition can be frightening and overwhelming for many people. Behavioral health professionals working in integrated care settings have the unique opportunity to intervene early to assist individuals with adjusting and adapting to the new demands for behavior change that accompany a new diagnosis.
Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ+) individuals are frequently underserved and experience significant disparities in health outcomes and accessing preventive and ongoing healthcare. Sexual and gender minorities (SGM) often experience discrimination and bias in health care settings and may delay or avoid medical and preventive care.
Developing safe, culturally competent healthcare environments and practices for LGBTQ+ patients is critical and closely related to individuals’ willingness to openly share their sexual orientation and/or gender identity and expression (SOGIE). Capturing SOGIE data is critical as it allows providers to have a more comprehensive picture of key factors that influence care.
This session will start with a brief discussion of SOGIE terminology and a compilation of what is known about medical and behavioral health needs and disparities among the LGBTQ+ community. We will highlight the critical need for creating environments that improve patients’ psychological safety and increase their willingness to share SOGIE characteristics. We will share examples of how this data could be utilized to improve care and patient satisfaction, including capturing a patient’s preferred name and pronouns, and ways to engage in respectful conversations that could reveal key aspects of their medical history that could otherwise go unnoticed.
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Integrated Care DC is managed by the DC Department of Health Care Finance (DHCF). This project is supported by the Centers for Medicare & Medicaid Services (CMS) of the U.S. Department of Health and Human Services (HHS). A total of $1,527,057.67, or 57 percent, of the project is financed with federal funds, and $1,147,478.36, or 43 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, CMS/HHS or the U.S. Government.