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value based payments

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Alternative Payments Making a Splash

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

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Full State Managed Care Review: All 10 Current Programs 2020

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

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A Fresh Approach to Managed Care in NC and NY

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 we have learned and what it means moving forward. North Carolina has been working with a form of managed care since 2005, but in 2015 committed to move towards a whole-person managed care approach. Their shift towards a new program has been halted due to legislation struggles and COVID-19, but… Read More »A Fresh Approach to Managed Care in NC and NY

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Local Engagement in IDD Managed Care with AZ and MI

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 is similar to that of North Carolina, focusing on county-based programs. These two contrasting styles have both found success and both have created unique solutions to manage the I/DD and MLTSS population. Arizona’s Managed Care Program Arizona’s Long-Term Care System (ALTCS) was established in 1998 for the management of Long-Term… Read More »Local Engagement in IDD Managed Care with AZ and MI

Is Telehealth the TSA of COVID-19?

Break Through Value-Based Payments Is Telehealth the TSA of COVID-19? THE VBP Blog For those of you who know me personally, you know that being an optimist is my downfall. In times of crisis, the ability to look forward to the forthcoming changes can be challenging.  Mandy, my co-author brings her creativity and technology-savvy perspective to our discussions. Together, we look ahead to the elements we want learn from.  Our starting point for this blog was the major change that came out of 9/11.  We jointly concluded that technology changed significantly because of that crisis. We also saw the TSA in our airports as one of the manifestations of the change.  So, could telehealth be the TSA of the COVID-19… Read More »Is Telehealth the TSA of COVID-19?

Onward Takes on New Meaning!

ONWARD Takes On A New Meaning THE VBP Blog Our blog has focused on the quality of services and how you can leverage measuring performance to continuously improve satisfaction, support our consumers, and keep you ahead of the game.  Today, the challenges you face are monumental, so we will focus on supporting you and live by our mantra, ONWARD! With hourly updates on the COVID-19 situation, having resources you can rely on is paramount. We want to make sure that you have resources for not only your consumers, but your staff and your business to ensure you make informed decisions. With that in mind, we have compiled both news articles and resources for you to reference. Here are a few… Read More »Onward Takes on New Meaning!

Pay for Performance – An Opportunity for Self-Direction in HCBS

Break Through Value-Based Payments Pay for Performance – An Opportunity for Self-Direction in HCBS THE VBP Blog Roughly a year ago we did a blog on Payment for Performance that took a look at the second step in the Value-Based Continuum. Pay for Performance (P4P) is the model that sets metrics to incentivize providers to achieve, advance, and exceed through their quality of care. We talked about the pros – sustainable metrics can lead to higher quality care – and the cons – lower social-economic status areas will have inevitable bad outcomes and thus receive less funding. The P4P model is undoubtedly the longest standing and fastest growing[2] above its counterparts in shared savings, bundling, and shared risk models.  In… Read More »Pay for Performance – An Opportunity for Self-Direction in HCBS

VBP Risk Capitation Pros and Cons

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 their consumers.   Do keep reading! It’s already shown success in California, where the state’s Regional Health Care Cost & Quality Atlas reveals the capitated-integrated model delivers on all the major VBP scores:  9% lower total cost of care, 14 points higher in quality, and $4,450 less in total cost of care… Read More »VBP Risk Capitation Pros and Cons

VBP Risk Sharing

Break Through Value Based Payments Risk Sharing in 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 not accomplished. It should not be approached lightly. Caption for Photo Risk Sharing and Reward A shared risk value-based model representing possibly the best of both of those worlds. Thought of as the “next-level” of value payment methods, risk-sharing is the ultimate opportunity for… Read More »VBP Risk Sharing