Leadership with a clear vision, commitment to VBP, and the ability to manage change is critical for the successful shift to VBP. VBP requires adjustments in internal processes and systems, such as data management, as well as cultural change. Strong leadership and organizational communication is a key factor in the culture change required for VBP advancement.
The decision to transition to VBP is multidimensional, sensitive to context and driven by a few key executives, especially the Chief Financial Officer in hospitals and health systems. Factors that play an important role in provider entities successfully navigating from volume-to-value include:
- Strong leadership vision;
- Long-term organizational commitment (as opposed to short-term shifting commitments);
- Upfront resource investment; and
- Ability to carefully design stakeholder incentives aligned with VBP objectives. (1)
“Leadership had to believe that VBP is the right thing to do and that they could make it work financially for the organization. At some point, providers will also recognize that VBP is the right thing to do and it will make their lives better.” Gregg Meyer, MD, MSc, chief clinical officer, Mass General Brigham Healthcare System and professor of medicine, Harvard Medical School. (2)
Senior leadership needs to ensure that its VBP strategy is deployed in a supportive manner across all internal business functions. Carefully consider who will participate in the VBP model rollout and how and when they will participate, including: staff (clinical quality, data, provider contracting, finance, project management), payer representatives, provider champions, and members.
Ask payers about resources that they may contribute, for example leadership training programs on topics that range from developing internal capacity for organizational learning and behavior change to practice variation analysis.
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)
While smaller and/or safety-net provider entities may not have a comparable executive suite or VBP team, it is still critical that key internal staff be charged with leading VBP implementation efforts. Staff may be more likely to have multiple operational, clinical, and/or financial roles. In addition, smaller entities may lack capacity to hire staff specifically for VBP roles and expertise. Consequently, clear internal accountability for VBP implementation, combined with external resources and best practices will be key to VBP success.
CMS’ Medicare Quality Payment Program offers support for small, underserved and rural practices