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Work Group Discusses the Next Phase of MLTC Value-Based Payment

The Department of Health (DOH) convened a meeting of its Value-Based Payment Work Group on May 21st. The meeting agenda covered a broad array of topics, including managed long term care (MLTC) value-based payment (VBP) arrangements. The Department noted that the State has met its fiscal year 2017-18 VBP goal – at least 10 percent of all managed care payments were made through VBP arrangements that involved at least upside risk (or pay for performance for MLTC payments). However, under the State's Medicaid VBP Roadmap, the required percentage of VBP spending and the level of risk involved increases sharply in 2018-19 and reaches 80 to 90 percent in April 2020.

The Department's plans for the next phase of MLTC VBP arrangements include both upside and downside risk and performance on selected quality measures. At a minimum, VBP arrangements would be required to incorporate the potentially avoidable hospitalization measure as well as an approved long term care measure.

LeadingAge NY will make available the slides from this meeting as soon as they are approved for publication. A stakeholder meeting on MLTC VBP is expected to be convened shortly.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124