As the market shifts toward increasing VBP use, including population-based payment (PBP) models, providers must be ready to implement more complex, transformative models. Moving toward new VBP arrangements requires operational and cultural changes while also offering provider entities the opportunity to restructure how care is delivered.
To be successful, you will need staff with new skills, the tools to support new VBP models, and strong leadership to support change management.
Step 1: Educate your team on VBP terms and models
Step 2: Assess internal interest and understanding of VBP
Step 3: Assess your readiness for a new or modified VBP model(s)
Step 4: Identify current data analytical capabilities and gaps
Step 5: Understand member attribution and assignment
Population-based Payment (PBP): Payment methodology between a payer and a provider entity that involves defining a budget/target on a per-capita basis for a defined population of patients for whom the provider assumes partial or full clinical and financial responsibility. PBP models can be condition-specific such as maternity bundled payments but can also be for a broader population of patients [APM Framework Category 3 and 4].