Looking at States’ Managed Care Programs: Iowa and Tennessee

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Break Through Value Based Payments THE VBP Blog Looking at States’ Managed Care Programs: Iowa and Tennessee Managed care has been a slow mover for the I/DD population in multiple states. As of 2019, there are 229,817 Medicaid consumers with an intellectual/developmental disability (I/DD) enrolled in Medicaid managed long-term services and supports (MLTSS) programs. In fact, only ten states have adopted a policy for populations with special needs at all.… Read More »Looking at States’ Managed Care Programs: Iowa and Tennessee

Quality Measures for the I/DD and MLTSS Communities

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Break Through Value Based Payments Quality Measures for the I/DD and MLTSS Communities THE VBP Blog In our last blog we anticipated breaking down the current state models for I/DD communities. However, we attended the Rehabilitation and Community Providers Association (RCPA) conference and presented to the MAX Group, where we learned that many providers aren’t as attuned to the quality measures available in this area. So, acting on the counsel… Read More »Quality Measures for the I/DD and MLTSS Communities

Lower Risk and Reward with Sub-Capitation

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THE VBP Blog One of the greatest areas of concern when we discuss capitation, is that it is “all or nothing.” However, that is not the case. In the development of Value Based Payments, there are ample opportunities to incorporate partial capitation, for specific services, events/episodes, and even treatments. As value-based options continue to take on more risk, we find ourselves looking at every alternative option. Capitation, as we covered… Read More »Lower Risk and Reward with Sub-Capitation

VBP Risk Capitation Pros and Cons

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Break Through Value Based Payments Part 10: Risk Capitation Pros and Cons THE VBP Blog Welcome back to THE VBP Blog Series. Continuing our drill-down into risk-sharing in Value Based Payments, in today’s blog we look at the capitation model. As the ever-challenging task of lowering healthcare costs continues to come to the forefront, organizations may look to capitation, which requires that providers take on the full financial risk for the care of… Read More »VBP Risk Capitation Pros and Cons

VBP Risk Sharing

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Break Through Value Based Payments The VBP Blog Welcome back to THE VBP Blog Series. As many of you have asked for continuing the global view of Value Based Payments, in today’s blog we look at how contracting entities take part in risk-sharing arrangements. This is usually an option for mature VBP organizations, with proven stable data tracks and clear quality controlled processes. Risk sharing involves actually foregoing revenues if goals are… Read More »VBP Risk Sharing

Shared Savings in VBP

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Break Through Value Based Payments Risk Capitation Pros and Cons The VBP Blog So, in preparing for our 8th installment of this blog series, it’s become evident that there’s a whole lot more than 10 portions of the topic to cover.  The progress through the Value Based Payments journey has many more steps and stepping stones than the initial view most of us have.  In the past two weeks, I had… Read More »Shared Savings in VBP

Succeeding with Payment for Outcomes

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Break Through Value Based Payments Succeeding with Payment for Outcomes The VBP Blog Value Based Payments are leading us to focus on the outcomes we can deliver and to have providers share in the savings.  However, the real success of payment for outcomes is in better health outcomes, longer periods without a need for higher-level care, and better quality of life for consumers.   The Advocate’s Perspective in this blog focuses… Read More »Succeeding with Payment for Outcomes

VBP Bundled Payments

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Break Through Value Based Payments Bundled Payments THE VBP Blog As we move Onward! Along the continuum of Value Based Payments, we examine Bundled Payments in this installment of our series. We have noted that some of these topics require more depth, so you may see our series expand to 12 or more…. This gives us the opportunity to share and advocate even more. Look for our Advocate Perspective below!… Read More »VBP Bundled Payments

VBP Payment for Performance

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Break Through Value Based Payments Payment for Performance THE VBP Blog We have received very positive response to this series and we continue to see the path of Value Based Payments as a progression, a journey from knowing what you do, how you do it and how well you do it, to capitalizing on the quality of what you share in the value of what you are delivering.  Our Advocate’s Perspective is… Read More »VBP Payment for Performance

VBP Payment for Process and Alternative Payments

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Break Through Value Based Payments Payment for Process & Alternative Payments THE VBP Blog Welcome back.  Our blog rolls on as we start to dive in the Value Based Payment (VBP) Continuum. The first steps on the continuum are Payment for Process & Alternative Payments. As we monitor changes in healthcare and move closer to the integrated VBP model, this first step is crucial for organizations as they prepare for the future. Look… Read More »VBP Payment for Process and Alternative Payments

VBP Payment for Value, Quality, and Outcomes

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Break Through Value Based Payments Payment for Value, Quality, and Outcomes THE VBP Blog Happy New Year! We hope 2019 is healthy and successful for you and yours. This is the third blog in our series. We want to continue to share the facts with you and encourage you to consider our Advocate’s Perspective…. And to share it with your colleagues. The transition from the Pay-For-Volume to the Pay-For-Value model marks… Read More »VBP Payment for Value, Quality, and Outcomes

Value Based Payments… What does it really mean?

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Break Through Value Based Payments Value Based Payments…What does it really mean? THE VBP Blog We are proud to include an advocate’s perspective as part of this blog… Read On. The adoption of value-based care is expected to account for 59% of all healthcare payments by 2020. Read that again. Now one more time. Let’s break down how we got here. Traditionally, payment for health services has run on a model called… Read More »Value Based Payments… What does it really mean?

Break Through Value Based Payments

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Break Through Value Based Payments A 10-Part Series of Blogs Focusing on VBP Blog 1: An Introduction and Path Onward Value Based Payments (VBPs) are coming: are you ready? We are launching a series of blogs diving into this hot topic to help you understand what it is, why it works, and how it can work for you. We will pepper each blog with relevant facts and finish each with a… Read More »Break Through Value Based Payments