powered by LeadingAge New York

DOH Webinar Describes VBP Tracking Process for MLTC Plans

The Department of Health (DOH) hosted a webinar last week for managed long term care (MLTC) plans to provide instructions for submission of the Value-Based Payment Tracking Report (VBPTR). The VBPTR collects information on the State's progress toward meeting its value-based payment (VBP) goals under its Medicaid waiver. The webinar slides are available here.

Key instructions from the webinar include the following:

  • Reporting is required for all Medicaid products, including partially-capitated MLTC plans, Medicaid Advantage Plus (MAP) plans, Programs of All-Inclusive Care for the Elderly (PACE), and Fully Integrated Duals Advantage (FIDA) plans.
  • Responses to the VBPTR survey should aggregate contract expenditures with providers across all Medicaid products. 
  • Responses by plans engaged in integrated products (i.e., MAP, PACE, and FIDA) should not include Medicare expenditures.
  • Penalties and recoupment of stimulus funding will be calculated based on data submitted in VBPTRs.
  • For partially-capitated plans, VBP Level 2 is defined as a pay-for-performance agreement between plans and providers where incentive payments are based on meeting performance targets for quality measures with the addition of a "'downside' or quality withhold" of at least 1 percent of total annual expenditures.
  • Partially-capitated plans should report only Certified Home Health Agency (CHHA), Licensed Home Care Services Agency (LHCSA), and Skilled Nursing Facility (SNF) spending, unless other providers are included in an approved "off-menu" arrangement.
  • PACE programs should report "all dollars in VBP Level 3 arrangements under Total Care for MLTC Subpopulation." (Presumably, this refers to all Medicaid dollars; however, the instruction is unclear. LeadingAge NY is seeking confirmation from DOH.)

MLTC plans are encouraged to submit any questions here.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838