Quality Measures
Payers participating in the Primary Care VBP model should tie primary care practice incentives to a common set of performance measures with flexibility for limited use of common Medicaid-specific measures by CCOs. Learn more about how quality is measured and how a practice can maximize performance improvement in VBP models generally in Section III Step 3 Understand how quality is measured and used in different VBP models and Section III Step 4 Maximize quality improvement and performance on measures.
OHA will convene a subcommittee to develop a common incentive measure set with a balance of child, adolescent and adult-focused measures. The target completion date of the measure set is Q1 2024.
Measures for which there have been substantial specification changes will be temporarily removed from the incentive methodology until new practice-specific and external benchmark data are available.
As part of the Primary Care VBP Model, practices should be rewarded for both high performance relative to external benchmarks and for improvement over time. External benchmarks can be national HEDIS benchmarks, statewide CCO benchmarks (for Medicaid), or statewide insurer-specific network benchmarks and aligned to the local environment. Learn more about how quality is measured and how a practice can maximize performance improvement in VBP models generally in Section III. Step 3 Understand how quality is measured and used in different VBP models and Section III Step 4 Maximize quality improvement and performance on measures.