Grants Pass Clinic has developed and implemented a variety of strategies internally and with external partners to achieve quality and cost VBP objectives.
- A partnership with the local behavioral health provider has increased behavioral health visits through warm hand-offs. It has been very successful, but recent staffing challenges have limited the ability of the partner organization to have staff onsite.
- A pharmacist group partnership for medication reviews, especially on patients who take over a certain threshold of medications, has reduced medication costs.
- Through their ACO, the clinic is reaching out to patients at the end of their life for comprehensive advanced care planning, including engaging family members.
- Clinic staff and clinicians are increasing the number of Advance Directives by asking patients about them at appointments.
- The clinic community health and behavioral health coordinator partners with many local agencies as well as pharmaceutical companies to help patients get their needs met.
Seek a common understanding of how payers define value in their VBP models and how these definitions align with your VBP team’s expectations. VBP arrangements are more successful if there is alignment. A VBP arrangement is a partnership between you and your payer partners to mutually and collectively target and improve defined measures of value.
Prior to embarking on a VBP initiative, consider the business case for participating in a VBP model. Objectives might include:
VBP Toolkit Menu
- Understand VBP models
- Educate your team on VBP terms and models
- Assess internal interest and understanding of VBP
- Assess your readiness for a new or modified VBP model(s)
- Identify current data analytical capabilities and gaps
- Understand member attribution and assignment
- Understand your population and health disparities
- Understand types of financial risk in VBP models
- Get ready for VBP
- Go live with VBP model(s)
- Promote provider clinical transformation to foster VBP success
- Access technical assistance and peer learning
- Understand how quality is measured and used in different VBP models
- Maximize quality improvement – performance on measures
- Review results and make modifications
- Scale up current VBP contracts and engage additional payers
- Understand VBP compact models
- Primary care model
- Specialty care models (future content)
- Hospital care model (future content)
- Improving care coordination, including transitions of care;
- Increasing clinic flexibility to provide team-based care, including integrating primary care with mental health care and care for persons with substance use disorders;
- Reducing overutilization, underutilization, and misuse of service by measuring and reducing unwarranted practice variation;
- Improving care for certain high-cost, high-need populations;
- Improving quality by closing care gaps (difference between best practice and actual practice);
- Improving patient experience and patient outcomes;
- Advancing health equity and addressing patients’ health-related social needs;
- Empowering patients;
- Reducing health care cost growth;
- Complying with OHA and other requirements;
- Remaining competitive – or getting ahead – in the local health care market;
- Increasing capacity to demonstrate quality improvement and ultimately take on more financial risk; and/or
- Improving negotiation leverage with other payers with increasing experience and a track record of successfully implementing VBP.
Without an intentional focus on equity, transformation and payment reforms may perpetuate or increase health inequities. Consider:
- To what extent are your payers focused on equity as part of their value objectives and the potential for inadvertently exacerbating health inequities?
- How will you incorporate reducing disparities and advancing health equity as part of your VBP value objectives?