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building pillars on the front of a building

The Four Pillars to Build On in a VBP Environment

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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 end of 2020, we offered our commitments as a company and in this blog we take a look at how those cross over. 4 Pillars of Reviewing Value-Based Care in I/DD Managed Care Time Matters: more than almost any other factor, the states that gave themselves time for a methodical… 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 regions in 2021, including many that were covered in our I/DD Managed Care Review blogs.  In those blogs, we covered the ten current programs being offered. Out of those ten, five (New York, Tennessee, Kansas, Arkansas, and Michigan) also have a PCF option.  This leaves us hopeful that PCF programs… Read More »The Primary Care First Model Explained

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 will be a two-part blog, starting with the national pieces and then working to a regional level. Fee-For-Service Models Traditionally, payment for health services has run on a model called fee-for service (FFS). This simple model means that physicians and healthcare providers delivered in units. This has little to do… 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 managing entity, how many consumers were affected, the role of case management, the rollout approach, and more. To make things a bit easier to compare, we also compiled a chart and a presentation [Full State Review Managed Care IDD ] for you to reference. Iowa & Tennessee Kansas & Texas… Read More »Full State Managed Care Review: All 10 Current Programs 2020

Let’s Jump Back in to Managed Care in I/DD

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Let’s Jump Back in to Managed Care in I/DD THE VBP Blog [5/14/2020] – For the past 8 months, we have touched on managed care in the individuals with intellectual and developmental disabilities (I/DD) population. While the world has been coping with COVID-19, this expansion of managed care has not slowed down. With the estimated 1.5 million Medicaid consumers with an I/DD, over 358,500 consumers with I/DD were enrolled in a managed long-term services and supports (MLTSS) program over 10 states as of May of 2020. This means approximately 2.1% of the total Medicaid population and 25.4% of I/DD consumers enrolled in a Medicaid program. This population has 45% with three or more chronic conditions and 35% always have a… Read More »Let’s Jump Back in to Managed Care in I/DD