1. Value Based Payment and Community Based Organizations
Thursday, October 19, 2017 MCC Community Based Task Force

2. Agenda What is Value Based Payment (VBP)? New York State Regulations
Contracting Considerations
Roadmap to VBP
            

3. What is value based payment?
A strategy used to promote quality and value of health care services.
The goal of VBP programs is to shift from pure volume-based payment, as exemplified by fee-for-service payments to payments that are more closely related to outcomes.

4. VBP Roadmap

5. Definitions
Level of risk Providers choose to share with the Managed Care Organization
Level 0 – No risk (FFS payments)
Level 1 – Upside risk only (FFS with shared savings available when outcome scores are sufficient)
Level 2 – Upside and Downside risk (FFS with risk sharing)
Level 3 – Upside and Downside risk (prospective total budget payment)
Community Based Organization Tiers
Tier 1 –Non-profit, Non-Medicaid billing, Community based social and human service organizations
Tier 2 –Non-profit, Medicaid-billing, Non-clinical service provider
Tier 3 –Non-profit, Medicaid-billing, Clinical support service provider

10. Resources Millennium Collaborative Care
NYS VBP library
Bootcamps and University
Social determinants of Health and community based organizations webinar
VBP subcommittee report and recommendations
SDH Intervention template
NYS path towards Value Based Payment
Health Impact in 5 Years Interventions from Centers for Disease Control:
NYS Prevention Agenda evidenced based interventions
VBP implementation: Community Based Organization