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LeadingAge NY Input Reflected in VBP Roadmap

During an April 8 meeting of the Value Based Payment (VBP) Workgroup, the Department of Health (DOH) reviewed changes made in the fourth draft of the Roadmap, a document laying out the State’s plan to move Medicaid payments from traditional Fee-For-Service (FFS) methods to alternative payment arrangements such as bundling, risk sharing and capitation.

LeadingAge NY’s written comments were reflected in the edits. Among the changes made in this version is a section that discusses the population eligible for Managed Long Term Care (MLTC) enrollment, and the need to consider Medicare savings though avoidable hospital use since Medicaid savings may be difficult to demonstrate for the chronically ill population. The document goes on to say that Pay For Performance (P4P) initiatives between managed care plans and providers (such as the nursing home quality pool) could be considered as Level 1 VBP arrangements. DOH plans to have a workgroup to explore this issue further.

Among the most recent changes made to the draft Roadmap are:

  • clarification that the Roadmap applies only to Medicaid payment reform and not to other payers;
  • managed care plans and individual providers can continue existing P4P contracts;
  • a mid-term evaluation of progress will be made at the end of year 3 to assess progress and address any VBP challenges; and
  • The State will work with providers and managed care plans to improve cost and quality data needed for VBP development.

The State invited LeadingAge NY and other workgroup members to nominate individuals to one of six subcommittees that will be charged with discussing implementation of the VBP Roadmap recommendations. The subcommittees are: (1) Technical Design; (2) Regulatory Impact; (3) Social Determinants of Health; (4) Community Based Organizations; (5) Communications; and (6) Integrated Care Services, and specifics on each group are posted here. LeadingAge NY wants to make certain that the perspective of Long Term and Post-acute Care (LTPAC) is heard in the subcommittee process, and is inviting its members to nominate individuals to serve. Please send Dan Heim the name and contact information for any volunteer by this Fri., April 17.

LeadingAge NY’s Task Force on Alternative Payment Arrangements, comprised of member providers and managed care plans, has been studying and making recommendations on VBP arrangements for LTPAC services, as well as provide ongoing feedback on the State’s VBP Roadmap. 

Contact: Dan Heim, dheim@leadingageny.org, 518-867-8866