Value-Based Payment Reform Academy: Advancing Value-Based Payment Methodologies for FQHCs and RHCs
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1 Value-Based Payment Reform Academy: Advancing Value-Based Payment Methodologies for FQHCs and RHCs FOR AUDIO, PLEASE DIAL: (866) ACCESS CODE: MARCH 10, :00-3:00PM ET This work is supported through NASHP s Cooperative Agreement with the Health Resources and Services Administration (HRSA), grant #UD3OA22891
2 Housekeeping! Please mute your line for today s call and do not put the line on hold! Use the chat box on your screen to ask a question or share a comment! Note: the chat box will not be visible if you are in full screen mode! Please complete the exit survey directly after this webinar
3 Who is NASHP?! 28-year old non-profit, non-partisan organization with offices in Washington, DC and Portland, ME! Dedicated to working with states across branches and agencies to advance, accelerate, and implement workable policy solutions that address major healthcare issues
4 Value-Based Payment Reform (VBPR) Academy: Goal! Goal: Work with states to develop and/or implement value-based approaches to Medicaid reimbursement for federally qualified health centers (FQHCs) and/or rural health clinics (RHCs) that align with states goals for transforming how care is delivered
5 The VBPR Academy: An Overview! Up to 6 states will be selected to participate by NASHP and an advisory group, which includes HRSA! State teams will consist of 4-6 members, including representation from:! Medicaid! Primary Care Association! FQHC or RHC! States will receive 12 months of targeted technical assistance! Seeking a wide range of state applicants Key Value-Based Payment Reform Academy Dates in 2016: March 10: RFA Informational Webinar April 1: Application due to NASHP April 21: Notification of selection to states Early May: Technical assistance period begins June or June 23-24: Kick- Off Meeting, location TBD
6 Defined: Value-Based Payment Reform! NASHP defines value-based alternative payment methodologies (APMs) as:! Incentivize value over volume;! Promote delivery of comprehensive, coordinated, and patient centered care;! Linked to quality and efficiency; and! Meet requirements of Medicaid reimbursement for FQHCs and RHCs under current federal law (the Medicare, Medicaid, and SCHIP Benefits Improvement Act of 2000)
7 Why Payment Reform?
8 Delivery System and Payment Reform Initiatives Spreading Nationwide 23 states actively making Medicaid payments to medical homes 20 states actively making Medicaid payments to health homes Source: NASHP s State Delivery System and Payment Reform Map,
9 State Example: Oregon! In 2013, Oregon implemented a value-based APM for a small pilot of FQHCs! Practices received per member per month (PMPM) payments! Each year practices total PMPM payments are reconciled against what they would have received through PPS! If total PMPM payments are lower, Medicaid pays each practice the difference! Since total payments equivalent to PPS, pilot is cost neutral for Medicaid Additional Resources about Oregon:
10 Benefits of State Participation in the Academy
11 Technical Assistance and Resources! Over the 12 months of the Academy, states will have access to a wide range of targeted individual technical assistance and peer-to-peer learning opportunities! Individual Technical Assistance! Support with developing a project plan! Access to expert consultation from national, federal, and state leaders! Ongoing access to NASHP staff, including a dedicated NASHP staff member to support each state team! In-person site visit to your states from NASHP staff! Monthly calls with each state
12 Technical Assistance and Resources, cont d! Group Technical Assistance! State-to-state virtual learning opportunities! In-person Kick-Off Meeting " Either June or June 23-24, 2016; location TBD " Funding available for meeting and travel expenses for up to 4 members of each state team
13 On-Call Faculty! Medicaid leaders! Primary Care Association leaders! Federal experts! National organization experts (such as NACHC and NAMD)! Health Systems and Provider Groups
14 How does my state apply?
15 Application Components! Required:! Identify and collaborate with core team members to complete the RFA Application Questions. Team members should include: " Senior Medicaid Leadership " Senior Primary Care Association Leadership " FQHC or RHC provider representative " Other, as relevant to your work! Completed RFA Application Questions! Optional, but encouraged:! Letters of support
16 Application Evaluation Criteria! All applications will be evaluated based on the extent to which they exhibit the following criteria. All criteria are weighted equally. Collaborative Transformative Quality- and efficiency-oriented Achievable
17 Application Process! Assemble core team and complete the RFA Application Questions (available here)! Send completed applications to Hannah Dorr by 5pm Eastern on Friday, April 1, 2016! States will be notified of their application status no later than April 21, 2016
18 Question & Answer To ask a question, please type it into the chat box in the lower left hand corner of your screen.
19 Thank You! Access the RFA and Application materials here: For questions or more information, please contact Rachel Yalowich
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