The CAPC Payment Accelerator: A Joint Virtual Workshop for Home-Based Care Teams-CAPC Payment Quick Tips

CAPC Payment Quick Tips - Value Based Payment Capabilities

Pdf Summary

Value-based payment (VBP) integrates quality and cost into the payment calculation for service providers. Organizations seeking VBP must develop five key capabilities:<br /><br />1. **Conducting an Opportunity Assessment**: Identifying potential contracting partners and their needs.<br />2. **Telling Your Value Story**: Communicating how your services enhance patient and utilization outcomes.<br />3. **Understanding Your Costs**: Knowing the costs to deliver services and ensuring measurable patient outcomes.<br />4. **Maximizing Efficiency**: Adapting services based on patient needs and collaborating with other providers to avoid service duplication.<br />5. **Nurturing the Relationship**: Regularly meeting with payers to problem solve and ensure mutual benefit.<br /><br />**Telling Your Value Story** involves demonstrating impact through data on reducing avoidable admissions, hospital costs, and enhancing patient satisfaction. Always include patient stories to illustrate the human impact.<br /><br />**Understanding Your Costs** requires calculating break-even volumes to ensure payments cover costs, adjusting pricing or finding solutions if break-even points exceed capacity.<br /><br />**Maximizing Efficiency** involves being a responsible steward of resources by serving patients likely to benefit, deploying teams based on patient necessity, and leveraging technology. It’s crucial to match patients to services efficiently, enrolling those who can benefit most and adjusting the service intensity based on need.<br /><br />**Revising Team Composition** in VBP involves using flexible team structures to match patient needs. Non-clinical tasks could be handled by para-professionals to optimize clinician utilization. <br /><br />**Telehealth** can boost efficiency, requiring preparation like selecting platforms, training staff, and ensuring patient support. Telehealth can be a convenient alternative to in-person visits.<br /><br />**Avoiding Duplicate Services** mandates coordination with entities like health plans and treating clinicians to offer additional care without redundancy.<br /><br />**Nurturing Payer Relationships** involves trust and regular meetings for communication and problem-solving. A structured schedule for operational, performance, and strategic discussions is recommended.<br /><br />Additional resources include tools and guides on payment partnerships, measurement practices, budgeting and financial analysis, patient engagement, population stratification, and telehealth setup.

Keywords

Value-based payment

Opportunity assessment

Value story

Cost understanding

Efficiency maximization

Relationship nurturing

Telehealth

Team composition

Duplicate services

Payer relationships