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Value Based Payment: Key Materials

Introductory Information:

·         VBP: An Introduction Video: Link   

·         VBP Overview VideoLink

·         Value Based Payment for Providers Video: Link

·         Webinar slides outlining the VBP RoadmapLink

·         Myths and Facts of Value Based Payment:  During this presentation, New York State’s Medicaid Director, Jason Helgerson, talks about common myths and facts about the Value Based Payment (VBP) initiative. He debunks common misunderstandings about the program and promotes the facts of what VBP actually means to those who are and will be participating in it.  Link

·         The VBP Roadmap outlines in detail, the direction NYS DOH is moving toward for contracts between Managed care organizations and providers.  The document is comprehensive, however very time consuming: Link

 

VBP Bootcamps:

The DOH released a series of materials walking organizations through Value Based Payment.  These materials are comprehensive, covering the basics of VBP through and advanced stages of contracting with Managed Care Organizations:

 

Bootcamp 1 - Introduction to VBP:  This introductory session will provide a clear foundational understanding of VBP, the implementation work that has been done to date, and where implementation is heading in the coming years.   The below topics are addressed in the materials:

1.       Introduction to Value-Based Payments

2.       High-level overview of VBP Readiness Assessment

3.       New VBP Design Standards:

a.       Technical Design

b.      Patient Engagement

c.       Social Determinants of Health

The following link contains the materials:  Link

 

Bootcamp 2 - Contracting and Risk Management: The second installment of the VBP Bootcamp series will familiarize participants with VBP contracting as well as risk management techniques. It will provide real life experience and examples of strategizing and contracting value-based arrangements. The below topics are addressed in the materials:

1.       VBP Contracting Overview:

a.       VBP Contracting Entities

b.      Presentation on two types of contracts:

                                                                           i.      Contract between a plan and a provider network (IPA/ACO)

                                                                         ii.      Contract between IPA/ACO and downstream providers

c.       Contracting considerations

d.      Contract necessities vs. optional items

e.      Contracting with Community Based Organizations

2.       Risk management mechanisms (stop loss provisions, risk corridors, etc.) and their importance in VBP contracting

3.       Leveraging analytics tools

4.       Advancement in risk levels

The following link contains the materials:  Link

 

Bootcamp 3 - Performance Measurement:  The final Bootcamp session is devoted to performance measurement and how performance results will impact the adjustment (upward or downward) in target budgets and shared savings/losses.  The below topics are addressed in the materials:

1.       Overview or Performance Measurement in VBP:

a.       Data

b.      IT guidance / considerations

c.       Rapid Cycle Evaluation

d.      Overview of the Process (Start to Finish)

e.      Provider / MCO / State expectations

The following link contains the materials:  Link

 

 

VBP University (VBP U)

VBP U is designed to be an academic resource to raise awareness, knowledge and expertise in the move to VBP. Although a certification is available, there is also training materials outlined on the DOH website.  The following is taken from the DOH website, https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/vbp_u/index.htm

 

VBP U – Freshman Year

Semester 1: Semester 1 of VBP U is designed to be a foundational curriculum for VBP. This semester gives an overview of the different levels of risk within VBP and the different VBP contract arrangement types.

Semester 2: Semester 2 of VBP U is designed to explain topic specific information around categories of importance in VBP including governance, stakeholder engagement, business strategy, finance, and data. The Semester 2 curriculum also includes provider specific information that details their role in VBP.

Semester 3: Semester 3 is designed to educate users on specific, important topic areas in the move to VBP. Topic areas include Social Determinants of Health, Community Based Organizations, and Contracting VBP. The curriculum for semester 3 includes videos on each of the topics as well as detailed guidance document targeted towards MCOs, Providers, and Community Based Organizations.

VBP U – Sophomore Year 2018

Semester 1: VBP U Semester One is designed to serve as a deeper dive into VBP fundamentals and includes, VBP Bootcamp course summaries, information on the Medicare Access & Children´s Health Insurance Reauthorization Act (MACRA), guidance for Chief Medical Officers (CMOs), and guidance for addressing social determinants of health through VBP.

 

Semester 2: VBP U Semester Two is designed to provide additional guidance related to Behavioral Health and Substance Use Disorder (SUD) in the context of Value Based Payments (VBP). Behavioral Health services and services to address SUD play critical roles in the strengthening of provider networks to improve health outcomes and create efficiencies. In many cases, strong links between physical health and Behavioral Health services, including SUD services, will establish provider networks that are truly capable of spanning the complete spectrum of care for an individual. The content contained within this release is intended to supplement VBP U's recent rollout and focuses on the five key principles of Behavioral Health.

 

 

Miscellaneous:

Value Based Payment (VBP) Baseline Survey was administered by NYS gathering details of current state payment arrangements between MCO’s and providers:  Medicaid MCOs VBP Baseline Survey Results (PDF)