Demystifying Value Based Payments€¦ · Demystifying Value Based Payments Fady Sahhar,...
Transcript of Demystifying Value Based Payments€¦ · Demystifying Value Based Payments Fady Sahhar,...
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Demystifying Value Based Payments
Fady Sahhar, XtraGlobex, Inc.
October 2017
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Agenda
• Welcome
• Defining Value Based Payments
• CMS Guidance on VBP
• The Pennsylvania Experience and MLTSS Application of VBP
• Getting Ready for VBP – Five Tenets
• Questions
October 2017
XtraGlobex VBP Readiness
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Defining Value Based Payments
• What is Value
• How Value is Works
• Why should you care
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XtraGlobex VBP Readiness
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The Pennsylvania Experience
• Health Choices History with VBP
• Behavioral Health History with VBP
• MLTSS
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XtraGlobex VBP Readiness
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Implications of PA Experience
• Not on day 1…. But it’s coming
• Rebalancing
• Quality
• Pay for Performance
• Measures of Quality
October 2017
XtraGlobex VBP Readiness
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Getting Ready for VBP in MLTSS
• Understanding • Processes
• Infrastructure
• Costs
• Quality Measurement and Improvement
• Leadership
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Understanding Your Processes
Define Key Processes in Your Operations
1
Process Mapping
2
Accountability
3
Process Streamlining
4
Process Improvement
5
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Understanding Your Infrastructure
Physical Infrastructure
Technology Infrastructure
People Infrastructure
October 2017 XtraGlobex VBP Readiness 8
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Understanding Your Costs
• Beyond accounting
• Aligning Processes and Costs
• Structural Costs
• Capital Costs
• Operational Costs
• Accountability for Costs
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Quality Measurement and Improvement
1
Define Quality
• Process
• Outcomes
• Satisfaction
2
Benchmarks
• National
• State
• MCO
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Establishing Quality Goals
• Pick Your Battles!
• Focus on goals that matter to:
• Consumers
• Stakeholders
• Regulators
• Payers / MCO’s
• Your Leadership
• Quality Goals to Differentiate Your Organization
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Measurement and Tracking
• Consistency
• Accuracy
• Oversight
• Transparency
• Reporting
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Culture of Quality
• Not a Project
• Clarity of Purpose
• Individual and Team Accountability
• Leadership Accountability
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Leadership
• Leadership Inventory
• Leadership Development
• Leadership Commitment
October 2017
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Questions / Discussion
October 2017
XtraGlobex VBP Readiness
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