The move to Value Based Payment (VBP) involves structuring and formalizing services into a continuum and weighing the treatment outcomes to performance requirements with known risks and costs. Preparation for entering into a VBP agreement involves a deep knowledge and ability to analyze and communicate about: clinical and demographic service population; risks to overall care, risks to episodes of care and risks to required outcome reporting; operational cost of care; projected cost savings to delivery system based on provider performance and lowered population risk; service definition in the bundled payment methodology; metrics definition for performance reporting; and, revenue management with strong manage care engagement and contracting. Metrics definition is essential to link services, outcome, risk and cost at a macro level with the ability to drill down to episodes of care and projected cost savings. A quality improvement and oversight mechanism to track successes and vulnerabilities must be built into the metrics definition and allow for corrective actions and process change because a VBP arrangement is a continuously active and dynamic evaluation of outcome and services.
View our webinar presentation: SAE and NYS Value-Based Payment Readiness (BHCC)