Strategies For Effective Quality Improvement In Value Based Arrangements – Cost of Care Part 4

Strategies For Effective Quality Improvement In Value Based Arrangements – Cost of Care Part 4

Description: This webinar explores the critical connection between the cost of healthcare services and quality outcomes. Attendees gained the skills to identify a set of meaningful metrics to monitor that inform strategic opportunities to elevate the quality of care...
Understanding Cost of Care to Drive Value-Based Payment Arrangements – Cost of Care Part 3

Understanding Cost of Care to Drive Value-Based Payment Arrangements – Cost of Care Part 3

Description: It is important for healthcare providers to understand the cost of the services they provide and compare that to reimbursement rates. In value-based care arrangements, they should also anticipate the impact of their care models on patient outcomes and...
Decoding Healthcare Finances Understanding Costs And Indirect Allocation Strategies Cost of Care Part 2

Decoding Healthcare Finances Understanding Costs And Indirect Allocation Strategies Cost of Care Part 2

  Description: With the District of Columbia’s movement to a reimbursement system with services defined and paid through a procedure code, health care leadership must understand the costs that are directly provided and those that indirectly support the service....
Supporting Practice Leaders Navigating Unfamiliar Waters – Leadership Through Change Part 1

Supporting Practice Leaders Navigating Unfamiliar Waters – Leadership Through Change Part 1

Practice leaders face more decisions than ever as the District of Columbia works to build an integrated health system that delivers whole person care. This learning series is designed to help organizational decision makers better manage change within a dynamic health system. Part 1 will introduce ways that leadership can transform ingrained policies and practices using new information, data points, and approaches to improve care access and outcomes. The session will also preview exciting next steps for the learning series moving into 2024.
Determining Cost of Provider Care – A Useful Business Management Tool – Cost of Care Part 1

Determining Cost of Provider Care – A Useful Business Management Tool – Cost of Care Part 1

Measuring the cost of providing services is critical for making informed business decisions. With the updated District of Columbia Medicaid Fee Schedule moving reimbursement of procedure codes for key behavioral health services from a per-occurrence basis to codes allowing reimbursement based on the amount of time spent providing these services, health care leadership must understand the costs that directly and indirectly support service delivery. This learning session will provide key decision makers, financial analysts, and practice management staff with an understanding of how to determine cost of care and how to compare cost of care with reimbursement rates to inform decision making.
Developing Your Value Based Payment (VBP) Value Proposition

Developing Your Value Based Payment (VBP) Value Proposition

In the dynamic landscape of healthcare, crafting a compelling value proposition involves a strategic blend of audience understanding, innovation, and responsiveness to the needs of payers, community partners and other stakeholders. This short take describes the steps to creating a strong value proposition.
Developing Your Value Based Payment (VBP) Value Proposition

VBP 101 (Teaching to the Tools) – VBP Foundations Part 5

The transition to Value-Based Payment (VBP) represents a multifaceted process, encompassing significant system-level adjustments in healthcare delivery and reimbursement. Effectively implementing these changes requires a methodical and developmental approach. To facilitate this transition, a comprehensive toolkit has been designed, empowering healthcare providers to evaluate their existing readiness and access resources essential for enhancing their capabilities to operate within a value-based payment framework. In this webinar, we will introduce providers to this invaluable toolkit and guide them on how to navigate it seamlessly.
Value-Based Payment (VBP) Virtual Learning Collaborative

Value-Based Payment (VBP) Virtual Learning Collaborative

Transitioning to payment models that support value-based care means doing business differently. Many District healthcare providers are requesting assistance preparing for and implementing this important change. This virtual learning collaborative focused on legal agreements, contracting, and financial topics, including revenue cycle management and assessing risk. Presenters shared scenarios, assessments, and tools to advance capacity and understanding.
How to Negotiate Your Share with Payers

How to Negotiate Your Share with Payers

This short take video will outline the elements of shared savings contract and where the “share” fits in. It will outline some of the key considerations to think about when trying to negotiate your share of savings with a payer for a value-based contract (including downside risk v. upside potential, contract structure, and other value-based care funding), as well as touch on internal considerations for providers when negotiating a share of savings (i.e. is the share enough to cover the provider’s investment to perform in the contract).
Key Considerations for Value-Based Payment (VBP) Arrangements

Key Considerations for Value-Based Payment (VBP) Arrangements

Value-Based Payment (VBP) arrangements with MCOs are generally described in a separate exhibit to a provider's managed care contract. This session will help participants assess the opportunities and risks of participating in VBP arrangements by evaluating legal terms associated with pay-for-performance programs, total cost of care programs, and capitation payment arrangements. Finally, the session will offer participants practice pointers for evaluating contract terms and examples of favorable and unfavorable VBP contract terms.
VBP Medicaid Managed Care Term Sheet

VBP Medicaid Managed Care Term Sheet

This tool helps FQHCs understand all of the various VBC elements that are encompassed in a model or program and can impact performance and hence are important consideration in the contract analysis. It provides the considerations, but also guidance on how to approach them and what may be favorable or unfavorable terms within a contract, depending on the scenario and LAN category.
VBP Terminology 101

VBP Terminology 101

VBP comes with lots of new vocabulary (and a deluge of new acronyms - including "VBP"). Come learn some of the key words, concepts, and constructs with which to understand VBP.
VBP Levels

VBP Levels

Different states (and the Health Care Payment Learning and Action Network) define different types of value-based contracts in different ways. Gain an understanding of the different types of VBPs and the path to them.
Primary Care Integration

Primary Care Integration

Studies have shown that $1 invested in integrating primary and behavioral healthcare will yield $4.50 in savings…and clients and providers both like integrated care better. Learn about the promises and pitfalls of primary and behavioral health integration.
Mergers & Acquisitions

Mergers & Acquisitions

One of the core concepts for VBP is attribution. Come learn about this critical component of the contracting process.
Attribution

Attribution

One of the core concepts for VBP is attribution. Come learn about this critical component of the contracting process.
Risk Adjustment

Risk Adjustment

CMS has signaled its intent to move from strict fee-for-service reimbursement to value-based payment for Medicaid as it has been actively doing for Medicare over the past decade. A few FQHCs are pursuing advanced alternative payment models on their own but most are choosing to clinically integrate with others, especially other FQHCs. This session will share national experiences from these initiatives and provide a framework for evaluating strategic options for DC FQHCs to progress in their pursuit of advanced alternative payment models.
Understanding Your Population

Understanding Your Population

Description: This resource emphasizes the importance of understanding a patient population for successful VBP and provides a foundational understanding of the key considerations in population assessment. Download the Tool
Technology Infrastructure to Support VBP

Technology Infrastructure to Support VBP

Description: This resource serves as a gap assessment for providers and a roadmap for the needed infrastructure to succeed in advanced value-based models. As providers transition from value-based payment models centered around quality performance to models with...
Succeeding in Advanced Alternative Payment Models

Succeeding in Advanced Alternative Payment Models

Description: This resource describes the competencies that providers must systematically master to thrive within each Health Care Payment Learning Action Network (LAN) category. At the very least, all alternative payment models (APMs) necessitate providers to achieve...
Quality Measurement for Behavioral Health Providers

Quality Measurement for Behavioral Health Providers

Description: This resource serves as a comprehensive guide, offering a step-by-step process for the creation of an integrated and comprehensive quality strategy. The strategy’s core components are thoroughly examined, encompassing population health outcomes and...
Promoting Value-Based Purchasing to the Behavioral Health Workforce

Promoting Value-Based Purchasing to the Behavioral Health Workforce

This resource is designed to assist leaders in introducing and educating staff about value-based payment (VBP) and value-based care, with a strong emphasis on leadership’s unwavering commitment to the program’s success. Achieving success in VBP arrangements hinges on garnering the full commitment of your workforce and ensuring their continuous participation in VBP activities. The materials provided offer valuable techniques for actively engaging your workforce in the development, implementation, and diligent monitoring of the VBP program.
Forming Strategic Partnership Agreements and Care Compacts

Forming Strategic Partnership Agreements and Care Compacts

Description: This resource introduces an initial approach for creating accountable and outcome-driven partnerships spanning the network of healthcare and community-based providers, all geared towards enabling comprehensive, whole-person care. The central focus is on...
Technology Infrastructure to Support VBP

Developing Your Value-Based Payment Value Proposition

This resource covers the development of a value proposition, a compelling statement or proposition that outlines the unique benefits and value that a healthcare provider or organization offers to payers, service recipients, and other stakeholders. A well-crafted value proposition helps healthcare providers and organizations communicate their unique strengths and advantages to payers and patients, ultimately driving engagement, partnerships, and success in value-based payment models.
Contracting for Value-Based Payment

Contracting for Value-Based Payment

This resource provides contracting tools to support value-based payment arrangements, beginning with a description of the components of legally enforceable contracts and the legal terms generally found in such contracts. The materials describe key legal considerations for arrangements between providers, which will assist providers in identifying and navigating potential legal issues. Recommendations are offered on how to address legal risks through the purchase of insurance, managing contracts throughout the contracting lifecycle, and negotiating contracts with other organizations.

Building a Positive Payer-Provider Partnership

Description: This resource provides strategies for cultivating a strong relationship with a Managed Care Organization (MCO) when entering into a value-based purchasing agreement. It provides insights into what the payer values and pinpoints measurable outcomes that...
Achieving Total Cost of Care

Achieving Total Cost of Care

Description: This resource assists providers in understanding the transition from value-based arrangements, which were previously constructed solely on the achievement of quality metrics, to models now grounded in the total cost of care. It furnishes providers with a...
Succeeding in Advanced Alternative Payment Models

Value-Based Payment: Is it Disrupting Health Care for the Better? Role of a Clinically Integrated Network – FQHC Part 3

Medicare, state Medicaid agencies, managed care organizations, and commercial insurers are increasingly adopting value-based payment (VBP) models. Community Health Centers (CHCs) are uniquely positioned to deliver on that high expectation by offering enhanced access to high quality primary care, coordinating the care delivered by specialists, hospitals and other institutions and care managing the most complex individuals. This requires CHCs to transform their care delivery to efficiently deliver optimal patient- and population-level health outcomes and successfully manage costs. Many CHCs are forming clinically integrated Networks to create contracting leverage, make joint investments in data analytics and collaborate to develop complex care management and clinical models of care.
Managing Expectations Related to Behavioral Health Carve-In

Managing Expectations Related to Behavioral Health Carve-In

https://www.integratedcaredc.com/wp-content/uploads/2023/09/Managing-Expectations-Related-to-Behavioral-Health-Carve-In.mp4   Description: Basic overview of legal requirements for DC’s Medicaid MCOs and how these requirements intersect with behavioral...
RAG Tool for Quality Measures and Contracts

RAG Tool for Quality Measures and Contracts

https://www.integratedcaredc.com/wp-content/uploads/2023/09/RAG-Tool-for-Quality-Measures-and-Contracts.mp4   Description: RAG is a tool designed to assess the viability of expectations related to quality metrics and reporting requirements providers may encounter...
Managing High Cost High Need Individuals – Behavioral Health VBP Part 4

Managing High Cost High Need Individuals – Behavioral Health VBP Part 4

High-need, high-cost (HNHC) patients often face multiple challenges including high disease burden, behavioral health comorbidity, functional limitations and social barriers to treatment plan compliance. They typically make up just 5 percent of the population, but account for 50 percent of health care costs. This webinar will discuss taking a tailored approach to care in order to improve their outcomes.
Allocation of Value-Based Payment Incentive Payments to Optimize Performance – VBP Foundations Part 3

Allocation of Value-Based Payment Incentive Payments to Optimize Performance – VBP Foundations Part 3

One of the greatest threats to success for clinically integrated networks is an uneven commitment from disparate providers to improve patient outcomes and reduce avoidable, low-value healthcare costs. Success depends on providers investing time and other resources to achieve performance targets. Although the distribution of value-based payments should certainly take into consideration the number of patients either attributed or served, it must also recognize the contribution each entity made to generate the incentive payments. This webinar will explore principles and examples of distribution methodologies aimed at fairly allocating those dollars.
Risk Mitigation and Risk Reserves

Risk Mitigation and Risk Reserves

https://www.integratedcaredc.com/wp-content/uploads/2023/09/Risk-Mitigation-and-Risk-Reserves.mp4   Description: Once health care providers have demonstrated the ability to reach quality performance targets and generate surplus in a shared savings pool, they may...
Developing Your Value Based Payment (VBP) Value Proposition

Data-Driven Insights to Advance Behavioral Health Quality – VBP Foundations Part 2

Advances in digital technologies and data analytics have created unparalleled opportunities to assess health data accelerating the ability of science to understand and contribute to improved health behavior and health outcomes. Additionally, behavioral health in the United States is being challenged to address persistent health inequities while improving the quality and value of the care delivered. As regulators, payors, and policies push behavioral health toward data-driven performance, the pressure for behavioral health providers to measure and monitor outcomes increases. This training will introduce providers to the key facets of using data to drive performance including metric selection, diagnosing performance issues and acting on data, driving innovation, and making data analytics a central part of the behavioral health quality strategy.

Where Quality Meets Legal – VBP Legal Training Part 3

This session will provide an orientation to quality initiatives implemented by MCOs in their managed care contracts. The session will explain the importance of these quality initiatives, the associated performance measurement reporting, and the contract terms that implement those quality initiatives. In addition, participants will be introduced to the VBP pathway so that regardless of current state of readiness, participants can understand the expectations of quality and be prepared to meaningfully assess these expectations in a VBP contract.
Measurement Based Care for VBP – Behavioral Health VBP Part 2

Measurement Based Care for VBP – Behavioral Health VBP Part 2

https://www.integratedcaredc.com/wp-content/uploads/2023/08/Measurement-Based-Care-for-VBP-–-Behavioral-Health-VBP-Part-2.mp4   Description: The use of measurement-based care (MBC) centers on the use of regular patient-reported outcome measures throughout their...
Accountable Care Organization (ACO) Fundamentals

Accountable Care Organization (ACO) Fundamentals

A basic overview of the structure and function of Accountable Care Organizations (ACO) as well as an exploration of their challenges and opportunities in advancing value based care contracts with the government and private payers.
Value-Based Payment: Is it disrupting health care for the better? Role of a Capitated Alternative Payment Model – FQHC Part 2

Value-Based Payment: Is it disrupting health care for the better? Role of a Capitated Alternative Payment Model – FQHC Part 2

This webinar will focus on the “why” of transitioning from fee-for-service to capitation to pay for community health center direct services. Dr. Jones will discuss how fee-for-service reimbursement limits patient access to care and hampers efforts to improve patient self-management and accountability for their own health. He will share examples of how innovators are using lessons learned from other service industries to disrupt the health care market. Participants will learn how moving away from the fee-for-service system can preserve revenue streams but also support new models of care, and how payment reform can help to address primary care workforce shortages.
Understanding Key Terms in Managed Care Contracts – VBP Legal Training Part 2

Understanding Key Terms in Managed Care Contracts – VBP Legal Training Part 2

Managed care contracts, like many legal contracts, are challenging to understand. This session will provide a roadmap to key terms commonly found in managed care contracts. The session will explain what these terms mean in plain language and offer examples of favorable and unfavorable terms. In addition, the session will offer pointers for evaluating the favorability of contract terms and describe potential changes to standard terms that participants may wish to address during negotiations.
Health Care Provider Checklist for Entering into Managed Care Contracts

Health Care Provider Checklist for Entering into Managed Care Contracts

This is a self-assessment tool intended to help health care providers plan for negotiations around proposed managed care contracts. The tool can be used for internal conversations to analyze key terms, develop strategic direction, and set priorities for approaching negotiations. This tool can help providers determine if they are ready to contract, what level of risk they can tolerate, and what areas to focus on in negotiations.
Promise and Perils of Value Based Purchasing VBP – Behavioral Health VBP Part 1

Promise and Perils of Value Based Purchasing VBP – Behavioral Health VBP Part 1

Value is a function of impact and cost. BH providers provide a very high-impact, relatively low-cost service. As such, payment methodologies that reward value should be an opportunity for them to increase their revenue. But that's a theory that only plays out in practice sometimes. Come learn what BH providers need to do to be successful in a value-based environment.
Clinically Integrated Networks: Build, Buy or Stay on the Sidelines – FQHC Part 1

Clinically Integrated Networks: Build, Buy or Stay on the Sidelines – FQHC Part 1

CMS has signaled its intent to move from strict fee-for-service reimbursement to value-based payment for Medicaid as it has been actively doing for Medicare over the past decade. A few FQHCs are pursuing advanced alternative payment models on their own but most are choosing to clinically integrate with others, especially other FQHCs. This session will share national experiences from these initiatives and provide a framework for evaluating strategic options for DC FQHCs to progress in their pursuit of advanced alternative payment models.
Strategies for Negotiating Managed Care Contracts – VBP Legal Training Part 1

Strategies for Negotiating Managed Care Contracts – VBP Legal Training Part 1

This is a self-assessment tool intended to help healthcare providers plan for negotiations around proposed managed care contracts.  The tool can be used for internal conversations to analyze key terms, develop strategic direction, and set priorities for approaching negotiations.  This tool can help providers determine if they are ready to contract, what level of risk they can tolerate, and what areas to focus on in negotiations.
LGBTQ+ Cultural Competency Training – Part 2

LGBTQ+ Cultural Competency Training – Part 2

https://www.integratedcaredc.com/wp-content/uploads/2023/06/LGBTQ-Cultural-Competency-Training-Part-2.mp4   Description: Lesbian, gay, bisexual, transgender, and questioning/queer (LGBTQ+) individuals are frequently underserved and experience significant...