![]() ![]() Level 2 or 3 – Consider a more defined network, as you are taking on risk and will be sharing risk with your provider partners.Level 1 – Potentially create a virtual network and engage in separate contracts with an MCO.Determine who your provider network will consist of:.Consider which risk level you will contract at (Level 1 – upside–only, Level 2 – upside and downside, Level 3 – prospective capitation).For providers, determine if you will be a lead VBP contractor or will be partnering with a lead VBP contractor.Determine who your partners will be, based on existing partnerships, geographic region, population type served, etc.For Off–Menu Arrangements, submission of an Off–Menu Supplemental Checklist and additional DOH review is required to ensure that the arrangement aligns with the intent of the VBP Roadmap.Ĭonsider taking the next steps to initiate or continue your transition to VBP.MCOs should review the VBP On–Menu Contract Review Checklist and ensure that each of the elements included in the checklist are incorporated in your contract, prior to submission.Managed Care Organization (MCO) submission of a MCO–Provider contract to DOH Review the VBP Contracting Lessons Learned 101 Video for additional best practices to consider when negotiating a VBP contract.Reference the Community Based Organization Guidance document for further information on strategies for contracting with CBOs. ![]() Consider partnerships with Community Based Organizations (CBOs), which are critical for addressing population health and social determinants of health.VBP contractors will want a robust network to cover the full care continuum and to ensure that providers that drive attribution are included in their contracts. Engage with your plan partner early and often.Specifically, reference the Provider Contract Statement and Certification to understand the standards for contract submission and review. Familiarize yourself with and utilize available resources (data from the State, technical assistance from potential partnering contractors, etc.).Assess your readiness and capabilities to take on risk. Know your business by understanding your mission, finances, ability to take on risk, data capabilities, partnerships, and timeline for State approval. Key Takeaways Negotiating a contractĭuring the negotiation phase, VBP contractors should consider the following leading practices: For further details, please reference the "Contract Risk Review Process" subsection of the VBP Roadmap. Specifically, the State has implemented a three–tiered approach under which the level of review needed is dependent upon the level of risk included in each submitted contract. The course also reviewed best practices for VBP contractors, as well as the DOH review process upon obtaining a submitted contract. This section serves as a summary of the 2017–2018 Value Based Payment (VBP) Bootcamp Contracting course, which highlighted key concepts and considerations for payers and providers as they negotiate and submit their VBP contracts to the New York State Department of Health (DOH). Social Determinants of Health course summaryįinance course summary 2017 – 2018 VBP Bootcamp: Contracting Course Overview VBP Arrangements and Associated Measures Sets course summary Summaries is also available in Portable Document Format (PDF).All Health Care Professionals & Patient SafetyĢ017 - 2018 Value Based Payment Bootcamp Course Summaries VBP U Sophomore Year: Semester 1 June 2018 NYS Medicaid Value Based Payment.Clinical Guidelines, Standards & Quality of Care.Health & Safety in the Home, Workplace & Outdoors.Birth, Death, Marriage & Divorce Records. ![]()
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