Implementing VBP involves different facets of payer and provider entity operations. For example, you need a robust quality program associated with the payment model and technical details of administering the payment model must be clearly understood and addressed.
Establish a multidisciplinary team appropriate to your provider entity’s size and scope with responsibility for managing VBP implementation and ongoing operations, and for engaging staff and clinicians in the work. Consider outside resources for support and technical assistance, including payer partners, provider associations and consultants.
For larger providers, the VBP team might include:
- Senior leaders who have decision-making responsibilities;
- Contracting staff who will negotiate the final details of a contract;
- Clinical staff;
- Quality management staff who help develop a quality strategy and discuss measurement with providers;
- Analytical and/or financial staff who can interpret data the plan might share with providers;
- Business, finance, and project management staff who can manage the internal operations of VBP implementation, including monitoring the fiscal impact; and
- Provider and payer staff who may serve as VBP champions to address questions regarding the payment model being proposed.
Small practices often rely on shared resources such as through an IPA, but also working with outside TA supports such as consultants. Many small practices need outside help with their EHRs for quality reporting and VBP success. Some successful providers have added a panel manager who reviews rosters, helps onboard new patients (when assigned), and coordinates with other staff responsible for outreach and recalls. These clinics also have a population health or quality committee that meets monthly.
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)
To support success in VBP arrangements West Hills Healthcare engaged leadership and staff to build a nimble team that leverages data to deliver the best care for patients. The clinic president tapped systems-level thinkers she knew were going to be excited about the new model and recognizes their hard work with a stipend for participation.
“You have to know your staff. Know who’s going to be excited and get them on board. We appreciate the time they’re spending and do as much as we can over email. When we need to meet, we give a stipend of $150 per meeting to recognize the value of their participation.”
Ashley Hyder, MD
Chief Operating Officer
West Hills Healthcare Clinic PC