Value Based Purchasing (VBP) is a payment strategy to measure, report, and reward excellence in health care delivery. Simply put, it is an effort to reward value over volume driving both COST SAVINGS and QUALITY HEALTH CARE.
PCG can support your organization across the spectrum of VBP strategies: from simple to complex, PCG will evaluate and tailor the strategy to meet your goals and the needs of your population.
VBP can benefit your state in multiple ways:
Improve Quality of Care through statewide health promotion efforts that incentivize patient and provider behavior change.
Curb rising health care costs through continued measurement, evaluation, and reimbursement tied to performance metrics.
Improve Care Coordination across primary and other providers of care by cent.
To understand how PCG can support your state in developing and operationalizing VBP initiatives, we have developed the VBP Toolkit. The VBP Toolkit is a straightforward roadmap to developing and operationalizing a VBP initiative. Using the toolkit, we highlight how PCG can support you along your VBP journey.
The Toolkit allows flexibility and is not an all or nothing proposition. There is no requirement to sign up for all aspects if you have already completed a program evaluation or have a draft design.
The toolkit ensures you can focus on YOUR goals!
The toolkit summarizes the process into the following stages:
The first step is evaluating your current Medicaid program, what goals you want to achieve with your program, and identifying how you could go about meeting those goals.
PCG can help conduct a gap analysis to identify where your Medicaid program needs assistance, identify VBP strategies and initiatives designed to address these concerns, and ensure alignment with legislative priorities.
PCG’s approach to assessment preparing for VBP includes:
No matter the direction you go in, it is vital to involve all stakeholders throughout the process. A robust stakeholder engagement plan, including communication methods, and training materials can help the success of a project.
PCG has extensive experience working with stakeholders in both an advisory and an educational capacity. We are adept in leading stakeholder engagement activities, including developing and delivering a communication plan to ensure providers and other stakeholders are kept informed while preparing for the development and delivery of future training. PCG can also support the development of survey tools to gather information about providers and their on-the-ground experiences and work directly with stakeholders to make sure concerns are heard and addressed.
Program design may include the development of:
All VBP initiatives need federal approval for implementation. This can be a time-consuming process involving lots of back and forth.
PCG has decades of experience navigating the federal approval process. From drafting state plan amendments and pre-print forms to responding to questions and being involved in discussions, PCG is well positioned to provide you with varying degrees of support throughout the process.
We work with and understand all federal health regulations including:
The implementation process, which follows once you have received federal approval, has many moving parts with different timelines and resource requirements. This includes but is not limited to continued stakeholder engagement, updating regulations, drafting policies, operationalizing data collection processes, data infrastructure preparations, provider education and training, and setting up program evaluation frameworks.
PCG is adept at developing detailed plans and timelines to support states in successful program implementation. Our project management processes identify risk and offer proactive solutions to navigate any implementation concerns. We have subject matter experts to work with your data collection tools, update policy guidance, and move the program from idea to reality.
Once the implementation phase is over and the program is up and running, there is still work to be done. From conducting data analysis and adjudicating payments to program evaluation and stakeholder training, ongoing program activities guarantee the continued success of the program.
With decades of experience in program management, PCG will make sure stakeholder communication is ongoing, and a regular cadence of training is conducted. With our trained staff dedicated to data analysis and robust performance tools, we will make sure payments are accurate based on data collection and all programs are running .
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