Value Based Payments Update
By Kathrine Panzarella, CPA, Director of Finance
VALUE BASED PAYMENT REFORM AIMED AT ENHANCING PERSON-CENTERED CARE
Millennium Operationalizing Vision; Launching Initiatives
The transition of the U.S. health care system away from fee for service (“FFS”) and towards shared risk and population based payment is necessary to achieving a value based health care system and the long-term sustainability of the changes being implemented through DSRIP.
Financial incentives to increase the volume of services provided are inherent in FFS payments, and certain types of services are systematically undervalued. This is not conducive to the delivery of person-centered care because it does not reward high quality, cost effective care.
Payment reform is required to ensure that the changes in the care delivery system funded by DSRIP are sustained well beyond the waiver period, so that member engagement and care coordination activities, including peer-based activities, can be reimbursed, and value-destroying care patterns do not simply return when the DSRIP dollars stop flowing.
Additionally, a stable and well-trained primary and community based workforce can be maintained, and dollars currently lost in non-value-added administrative processes become available for member care. Importantly, payment reform is equally essential to ensure that the savings realized by DSRIP can be reinvested in the Medicaid delivery system.
Upon CMS approval of the Value Based Payment (“VBP”) Roadmap in July 2015, the work of operationalizing the vision for payment reform commenced. New York State has committed to achieving the goal of having 80% of all Medicaid payments in a value based arrangement by the end of the waiver period.
Millennium management, along with its Finance Committee, VBP Subcommittee and related workgroups, have undertaken this effort and have begun the strategic planning process to achieve the goals set forth by New York State. We have significant initiatives underway related to VBP including strategies addressing communications, education, payment models, partner readiness, and managed care organizations (“MCOs”).
We are currently focusing on assessing partner readiness in the form of a survey that was released to a group of partners in mid-July. Additionally, we have begun discussions with our assigned MCOs to identify shared goals and where our strategies align. Finally, educational presentations are being prepared by the PPS to ensure our partners properly understand VBP.
Questions related to VBP, suggestions for educational offerings, and any other communications should be sent to our VBP email address at: Value-Based-Payment@millenniumcc.org.
AUDIO/VISUAL EDUCATION PRESENTATION: Value Based Payment 101 Presenter: Karen Blount Karen is Chief Medical Officer for TOG, LLC. She is a managed care leader with experience in network development, contracting and population health. She has extensive experience leading women and children’s health across the continuum and possesses a transitional leadership style with strong team-building and reorganization skills. She has a strong clinical background, excellent relations with multi-disciplinary professional colleagues, and a strong commitment to leadership development and outcome evaluation of leadership transitions.