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Value-Based Payment

Value-Based Payment

CMS Announces GUIDE Model for Medicare Beneficiaries with Dementia

The Guiding an Improved Dementia Experience Model aims to improve the quality of life for people with dementia, while helping them to remain at home and reducing strain on unpaid caregivers, by providing an alternative payment arrangement for providers of supportive services. Letters of Interest to participate in the Model are due by Sept. 15, 2023.

6 months ago

Value-Based Payment

DOH Releases Final Update to Medicaid Value-Based Payment Roadmap

Under the proposed 1115 waiver, the value-based payment framework described in the Roadmap will drive a substantial investment in the State's health system.

1 year ago

Value-Based Payment

Highlights of February 2020 Plan Meeting

DOH announced a delay in the implementation of the MLTC nursing home benefit limit due to a systems issue. The transition of long-term nursing home residents from MLTC to FFS will not take place on March 1st upstate, as previously planned. The expected duration of the delay and whether it will affect the NYC transition were not known at the time of the meeting. The meeting also included updates on quality measure reporting, provider network submissions, and Medicare-Medicaid managed care procedures.

4 years ago

Value-Based Payment

DOH DSRIP Phase 2 Webinar Offers Additional Detail on Waiver Plans

DOH hosted a webinar on Dec. 11th to share details with stakeholders on the recently submitted application to extend and renew the State's DSRIP Program waiver. The webinar highlighted the successes of the first phase of DSRIP and described how the second phase would expand and strengthen the VBP arrangements initiated in the first phase.

4 years ago

Value-Based Payment

VBP Measures for PACE and MAP Plans to Resume in 2023

DOH had suspended its calculation of value-based payment measures as a result of the COVID-19 pandemic. It resumed calculation of the Potentially Avoidable Hospitalization measure in measurement year 2021 and will calculate all Category 1 measures for PACE and MAP plans for 2023.

1 year ago

Value-Based Payment

DOH Releases 2022 Draft VBP Roadmap for Comment

The 2022 VBP Roadmap Update would make VBP arrangements optional for partially capitated MLTC plans and their network providers. PACE and MAP plans would continue to be subject to VBP arrangements.

2 years ago

Value-Based Payment

DOH Value-Based Payment Work Group Discusses Next Steps in VBP

The Work Group met on Dec. 11th to discuss strategies for strengthening and expanding VBP arrangements under Medicaid managed care and MLTC.

4 years ago

Value-Based Payment

Highlights of December Plan Meeting

The December managed care plan meeting with DOH covered a variety of new and long-standing MLTC issues, including updates on the nursing home benefit limit and MLTC enrollment lock-in, integrated Medicare-Medicaid managed care policies, the transition of FIDA program enrollees, VBP contract submission deadlines, CINERGY payments, DSRIP 2.0, and MLTC model contracts, as well as new requirements governing crossover coordination of benefit agreements.

4 years ago
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