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Subcommittee Meets on Value-Based Payment for Integrated Managed Care Plans

The Department of Health (DOH) convened a second subcommittee meeting last week to consider value-based payment (VBP) models and quality measures for managed care plans that cover both Medicare and Medicaid benefits, such as Programs of All-Inclusive Care for the Elderly (PACE), Fully Integrated Duals Advantage (FIDA) plans, and Medicaid Advantage Plus (MAP) plans. The initial meeting was interrupted by technical difficulties. A summary of the initial meeting is available here, and the slides presented at the meetings can be accessed here.

The second meeting focused on potential quality measures for VBP under integrated managed care plans. The Department acknowledged the sample size challenges associated with quality measurement in programs and plans with low enrollment. To guide the selection of quality measures for use in VBP arrangements, it recommended the use of outcome measures rather than process measures. LeadingAge NY noted that many preventive services are evaluated based on process measures and questioned whether it is advisable to omit process measures entirely. The Department asked stakeholders to consider whether quality measures for VBP under integrated plans should be limited to existing measures applied to the partially-capitated MLTC program and the Medicare Advantage program, or whether additional measures drawn from the mainstream Medicaid managed care program and other sources should be used. Stakeholders are urged to submit feedback by email here.

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