Value Based Payment (VBP) 101 Education

By DSRIP Year 5 all Medicaid Managed Care Organizations (MCOs) must transition to value-based payments (VBP) for at least 80–90% of their provider payments.

  • The state will show benchmarks and give guidance—will not set rates
  • There are a variety of options outlined in the roadmap—many details to be negotiated between MCOs and providers
  • The state is committed to ensuring adequate reimbursement aligned with the value provided for the Medicaid population consistent with Federal Statute
  • Reducing lower-value care (ED admissions/re-admissions and ambulatory sensitive admissions) and increasing higher care value in equal portions = higher margins for providers
  • MCOs may contract with providers directly or through PPS as it evolves; PPS should be utilized as administrative and best practice support moving forward
  • Roadmap pertains only to Medicaid payment reform




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One thought on “Value Based Payment (VBP) 101 Education

  • cag766

    Posted February 17, 2017 at 11:58 am

    the course was very informative for the vna management team

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