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.

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.

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.

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. 

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 Eligibility, as well as inclusion in HRSA BPHC Uniform Data System (UDS) CY2023, Million Hearts, CMS Quality Payment Program (QPP) - 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.

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.

Value-based care focuses on improving patient outcomes while optimizing total cost of care. For health centers seeking to improve their internal processes for value-based care, effective data visualization can play a significant role in understanding, monitoring, and promoting value-based care practices. This resource details how data visualization can be employed to support value-based care and includes suggestions on how to depict measures and trends using data dashboards.

This website includes resources to support health care’s transition to alternative payment models.