value based payments

doctor using a marker to draw a heart beat wave growth trends

Value-Based Payments Growth Trends…. Are You Ready?

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Value-Based Payments Growth Trends…Are You Ready? THE VBP Blog We are exploring value-based growth trends this week. Current data shows Medicaid managed care programs using value-based payments programs have experienced steady growth over the past few years, 67% of Medicaid’s 74 million consumers are enrolled in some type of health plan and 55% of Medicaid budgets are going to health plan payments. Of all Medicaid MCO respondents, 93% utilized a… Read More »Value-Based Payments Growth Trends…. Are You Ready?

building pillars on the front of a building

The Four Pillars to Build On in a VBP Environment

Four Pillars to Build On in a VBP Environment THE VBP Blog [1/14/2021]  In 2020, we took on the monumental task of evaluating all ten states that offered managed care programs for the Intellectual and Developmental Disabilities (I/DD) population. In our final blog of that series, we broke down our findings into four main pillars. These frameworks provided structure across the many different approaches over the ten states. At the… Read More »The Four Pillars to Build On in a VBP Environment

primary care

The Primary Care First Model Explained

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The Primary Care First VBP Model Explained THE VBP Blog [12/17/20] The Primary Care First (PCF) model was established by the Centers for Medicare & Medicaid Services (CMS) Innovation Center. It offers a regionally-based, multi-payer approach to primary delivery and payment. By design, PCF allows for increased flexibility and freedom for practitioners to be innovative in their approach to increase quality and reduce costs.  PCF will be offered in 26… Read More »The Primary Care First Model Explained

stark law

CMS’ Overhaul Could Mean VBP is Working for Consumers

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CMS’ Overhaul Could Mean VBP is Working for Consumers The Stark Law has been modernized: Here’s what you need to know THE VBP Blog [11/24/20] This week, CMS announced they were modernizing and updating the Physician Self-Referral Law (i.e. “Stark Law”) to steer it towards a value-based payment (VBP) structure. The core of the law, to protect patients from unnecessary, low quality, and expensive services, will stay in-tact. The new… Read More »CMS’ Overhaul Could Mean VBP is Working for Consumers

black woman and her nurse

Pay-for-Performance – Developing and Expanding Opportunities

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Pay-for-Performance Developing and Expanding Opportunities THE VBP Blog We are circling back to cover pay-for-performance, the second stop on the value-based payment continuum. The pay-for-performance (P4P) model gives providers bonuses for hitting quality and efficiency targets. As we continue to focus on whole-person care, the new normal of hybrid payments continues to shift.   According to Health Care Payment Learning & Action Network (LAN), in 2018, 25% of all fee-for-service… Read More »Pay-for-Performance – Developing and Expanding Opportunities

older woman with flowers bundled payments

Exploring Bundled Payments

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Exploring Bundled Payments THE VBP Blog When we started the VBP Blog back in 2018, we broke down the building blocks in the continuum for Value-Based Payments. In the last blog, we revisited Alternative Payments and what had changed since our original analysis. In this one, we will be covering Bundled Payments and what they mean to Value-Based Payments. Bundled Payments Refresher As a refresher, bundled payments – also known… Read More »Exploring Bundled Payments

Elderly couple sitting by ocean

Alternative Payments Making a Splash

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Alternative Payments Making a Splash​ Examining the ever-changing Value-Based Payments landscape​ THE VBP Blog Value-Based Payments are a complex topic that is evolving very quickly. Back when we first started this blog in 2018, we began at the very beginning. We feel it’s important to double back on those foundational pieces of VBP as it continues to change. With that in mind, we are starting with Alternative Payment Models. This… Read More »Alternative Payments Making a Splash

elderly senior being brought meal by a nurse

Full State Managed Care Review: All 10 Current Programs 2020

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Full State Managed Care Review: All 10 Current Programs Is Provider-Led Care the Future of Managed Care Programs? THE VBP Blog [July 30, 2020] Across several months and multiple blogs, we have covered all ten states that feature managed care programs for the Intellectual and Developmental Disabilities population. We saw a wide range of successes, types of programs, and different phases of rollout. With each, we broke down the state’s… Read More »Full State Managed Care Review: All 10 Current Programs 2020

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A Fresh Approach to Managed Care in NC and NY

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Fresh Approach to Managed Care in NY and NC THE VBP Blog We’ve navigated you through 8 of the ten states with a managed care I/DD program and in this blog, we will cover the final two. We have learned a lot about the different approaches, the successful and not as successful programs, and the work that is still left to do. In our next blog, we will recap everything… Read More »A Fresh Approach to Managed Care in NC and NY

older couple hugging

Local Engagement in IDD Managed Care with AZ and MI

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Local Engagement in IDD Managed Care in Arizona and Michigan THE VBP Blog [5/26/2020] – As promised, this blog will examine the last 4 states that offer I/DD managed care programs to their consumers. This week, we take a look at Arizona and Michigan. Arizona built a completely different structure than we have seen before with a state-run Division of Developmental Disabilities as the managing entity. Michigan’s managed care program… Read More »Local Engagement in IDD Managed Care with AZ and MI