Payer Mix Analysis Tool
Payer Mix Analysis Tool
This Excel tool helps health centers conduct a strategic review of their health plan contracts - across all product lines including Medicaid, Medicare, and Private/Commercial - to ensure their organization's financial sustainability and capacity to expand services to meet community needs.
Value Based Care Basics Module 3
The Value Based Care Basics training is a three-module series. All three modules can be completed by health center leaders to gain a working knowledge of value based care and how to successfully implement it at your health center. This third module includes a video and companion resource related to utilizing payer data.
Value Based Care Basics Module 2
The Value Based Care Basics training is a three-module series. All three modules can be completed by health center leaders to gain a working knowledge of value based care and how to successfully implement it at your health center. This second module includes a video and companion resource related to Managed Care data.
Value Based Care Basics Module 1
The Value Based Care Basics training is a three-module series. All three modules can be completed by health center leaders to gain a working knowledge of value based care and how to successfully implement it at your health center. This first module, including the video and companion checklist, uses the Health Care Payment Learning & Action Network (HCP-LAN) Alternative Payment Model (APM) Framework as its basis.
[Video] Managed Care Data and Contracting in Practice
This video provides practical information on utilizing payer data to support population health and contracting goals in practice.
[Video] The Managed Care Data Set
[Video] The Managed Care Data Set
This video module helps health centers to understand how payers use data to evaluate their performance, to learn how to incorporate data into practice to improve value-based payment opportunities, and to prepare with best practices around organizing managed care data.
Clinical Quality Measures for Eligible Professionals: 2023 Update
Clinical Quality Measures for Eligible Professionals: 2023 Update
This spreadsheet developed by the HITEQ Center provides a crosswalk of Clinical Quality Measures and their electronic specifications as defined in the 2023 update for Eligible Professionals (Clinicians). Fields include the crosswalk of measures with related information about CMS, NQF, and MIPS ID, and Telehealth Eligiblity, as well as inclusion in HRSA BPHC Uniform Data System (UDS) CY2023, Million Hearts, CMS Quality Payment Program (QPP) - APM Performance Pathway (APP) Measures, Medicare Shared Savings Program (MSSP)/ CMS ACO Shared Savings Program, CMS Core Set (Child Core Set Medicaid / CHIP): HEDIS Specified, CMS Core Set (Adult Core Set Medicaid): HEDIS Specified, Core Quality Measures Collaborative (ACO / Primary Care). Links are included throughout.
Managed Care Glossary for Health Centers
Glossary of managed care and value based payment terms that may be useful to health centers and health center stakeholders beginning to explore this topic.
Managed Care Data Checklist for FQHCs
This checklist will walk you, the health center, through a series of common considerations for contracts you may receive from payers with a specific focus on contracts that include value-based payment components. This document assists organizations in understanding the necessary data and data-related tools for managing population health within a managed care environment. It is a primer on the types of best-practices that are necessary to maximize care delivery models that are responsive to value-based payment programs. Follow this checklist to further your understanding of these considerations and to help flag any outstanding issues for legal and/or consultant review prior to execution.
Value Based Payment Contract Review Checklist for FQHCs
This checklist will walk you through a series of common considerations for contracts you may receive from payers, with a specific focus on contracts that include value-based payment components. Work through this checklist to be sure you understand these considerations and to help you flag any outstanding issues for legal and/or consultant review prior to execution of the contract.