Value-Based Payment (VBP)

In this informational discussion, speakers from the Centers for Medicare & Medicaid Services (CMS) Center for Medicare and Medicaid Innovation (CMMI) provided an overview of the Long-term Enhanced ACO Design (LEAD) Model and opportunities for state participation. LEAD includes a novel Medicare-Medicaid integration component that has not been tested in previous CMS ACO models and programs. Under this component, ACOs will be able to partner with plans and states to offer a more comprehensive, integrated approach to serving full-benefit dually eligible individuals with Original Medicare.

This webinar provides an overview of two health plans' approaches to Medicare-Medicaid value based purchasing (VBP) with nursing facilities. The presentation also features a panel discussion on Medicare-Medicaid nursing facility VBP with discussants from health plans, state Medicaid departments, and nursing facilities from Arizona and Minnesota.

This brief describes value-based payment approaches currently used in select states and managed care plans, including the quality and performance measures they use, benchmarks or targets for those measures, and incentives that reward facilities. It also describes approaches to designing, administering, and evaluating state programs.

Value-Based Payment (VBP)

Using the LEAD Model to Better Coordinate Care for Dually Eligible Beneficiaries in Original Medicare

Using Value Based Purchasing (VBP) Arrangements to Improve Coordination and Quality of Medicare and Medicaid Nursing Facility Benefits

Value-Based Payment in Nursing Facilities: Options and Lessons for States and Managed Care Plans