[Video] FQHC Value Based Payment Basics
[Video] FQHC Value Based Payment Basics
In this 25 minute video we cover the basic mechanics of how FQHCs are paid, the prospective payment system, and how it is evolving over time. We also review the spectrum of value-based payment arrangements using the HCP-LAN framework as a guide. We also discuss the capacity needed to be successful in each of those payment categories. Patient attribution process, including why that data is so critical in value-based payment arrangements, and what questions to ask payer partners about attribution processes are also reviewed. Lastly, a real value-based payment arrangement and related considerations are reviewed.
[Video] Managed Care Data and Contracting in Practice
[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.
1332 Waivers and Health Centers
1332 Waivers and Health Centers
This document offers an overview of the Affordable Care Act (ACA) Section 1332 waiver option (or “state innovation waiver”) and key information to help health centers engage in the development of state innovation waivers in their states.
Adopting Accountable Care
Adopting Accountable Care
This toolkit addresses four key issues for practices interested in engaging with ACOs: 1) Risk management; 2) Referral networks; 3) Actionable data systems; and 4) Patient engagement. The toolkit provides detailed steps to be taken to address these four critical issues.
An Evaluation of the Cost Efficiency of Federally Qualified Health Centers (FQHCs) and FQHC ‘Look-Alikes’ Operating in Michigan
An Evaluation of the Cost Efficiency of Federally Qualified Health Centers (FQHCs) and FQHC ‘Look-Alikes’ Operating in Michigan
This research report describes its methodology and findings that Michigan health center Medicaid patients have lower monthly costs compared to Medicaid members who are not health center patients.
Are Health Centers Cost Effective?
Are Health Centers Cost Effective?
These slides are from a HRSA/BPHC Webinar Thursday, July 23, 2015 reviewing the most recent research studies of health center cost effectiveness. The slides from this webinar describe the research methods by leading health economists finding that health centers generally exhibit lower total costs of care and better patient outcomes compared to other primary care providers.
Better Evidence. Better Decisions. Better Health: Payer Perspectives
Better Evidence. Better Decisions. Better Health: Payer Perspectives
Payers are in a unique perspective to drive the use of evidence in practice. Whether through coverage decisions, utilization review, or coinsurance, there are many strategies payers use to reflect the value of specific therapies within the marketplace. So, what information do payers feel they need to guide these efforts? Raj Sabharwal, M.P.H., Director at AcademyHealth will discuss his article “Developing Evidence That Is Fit for Purpose: A Framework for Payer and Research Dialogue,” which describes efforts to develop and refine a decision-making framework that considers payers’ perspectives on the utility of evidence generated by different types of research methods, including real-world evidence. Panelists from the National Pharmaceutical Council and AcademyHealth’s Corporate Council and will provide insight into the decision-making framework and will provide perspectives from their own institutions.
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.
Coding Social Determinants of Health (SDH) for Optimizing Value
Coding Social Determinants of Health (SDH) for Optimizing Value
The purpose of the infographic is to describe how SDH data would be used for a variety of goals that would have traction with the clinic staff audience who may likely need to modify workflows and behavior in order to collect such data. The visual case could be used in presentations or hung on a provider break room wall.