We take a look at Arkansas’ provider-led network as a groundbreaking new model for Medicaid consumers. Their whole-person approach is a true example of what value-based care can offer consumers and providers.
As of July 1st, North Caroline shifted to a Medicaid Managed Care Program. Almost 1.6 million beneficiaries are now receiving the same care in a new way through Medicaid Managed Care health plans.
New care delivery models that focus on tech could assist with the adoption of value-based care
The North Carolina Department of Health and Human Services (NCDHHS) opened enrollment for NC Medicaid Managed Care.
Nationwide, the children under 21 enrolled in Medicaid crew to 40.5 million in 2017 from just 23.5 million in 2000.
The South Carolina Department of Health and Human Services (SCDHHS) recently added Humana Inc. to its Healthy Connections Medicaid program and its Healthy Connections Prime program.
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 payments had a link to quality or value, including pay-for-performance models. To understand more of the basics, you can check out our first blog covering P4P. Pay-for-performance is a payment model that attaches financial incentives to provider performance. Incentives can range from small bonuses to large payments, depending on the… Read More »Pay-for-Performance – Developing and Expanding Opportunities
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 as episode-based payments (EPMs) – are an alternative payment method (APM) in which services are grouped together and a target price is calculated. This target price is the total allowable expenditure throughout an entire episode of care. A bundled price can be set and adjusted based on risk factors, age,… Read More »Exploring Bundled Payments
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
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