Assess internal interest and understanding of VBP

Consult with clinicians and your staff involved in financial management, data management and quality improvement to determine if they understand VBP generally, Oregon’s rationale for moving away from a traditional FFS payment system, and the models being promoted by the VBP Compact. Strategies to address VBP readiness are discussed in Section I Step 3 Assess your readiness for a new or modified VBP model(s). Make the case for why healthcare payers are moving away from FFS arrangements in order to align incentives at the provider level to produce quality over quantity. If you need help making that case internally, seek support from payers, provider associations, management service organizations or health care consultants.

Talk to your staff with operational, financial, quality, and clinical responsibilities about various VBP arrangements to identify opportunities for the clinic and possible concerns. Clarify how payment arrangements might vary across payers and across different VBP models. Share why leadership prioritizes VBP for the organization and where it falls among organizational priorities. Areas to investigate include the following queries.

  • Do your clinicians and key staff understand why the FFS status quo is not sustainable or desirable?
  • Do your primary care clinicians understand which payer members are attributed or assigned to them for VBP and performance measurement approaches?
  • Do they understand the use of performance measures, financial incentives, opportunities, and risks in different types of VBP arrangements?
  • Have they participated in any VBP arrangements to date? How do they view that experience?
  • Do they understand how your participation in VBP aligns with payer goals and broader environment?
  • Do they understand how VBP success is based on an active partnership between providers and payers that requires cultural and operational changes to advance shared goals?

For Providence Medical Group, team-based care and the medical home model have been core to their operations for many years, positioning them well to enter VBP arrangements. To facilitate the speed and ease of implementation across Providence’s over 35 clinic sites, leadership established a practice coach team to develop an implementation guide and round with clinical teams every day in the early stages of transformation. The practice coach team worked one-on-one with clinics to build teams of medical assistants, providers, behavioral health providers, pharmacists and care management staff. With clinical teams in place the practice coach team then worked with clinics to build the financial and quality infrastructure to be successful in VBP arrangements. Clinics with the most success in transformation had physician champions.