Financing Integrated Social Services for the High-Need, High-Cost Population: Webinar and Resources

Caring for high-need, high-cost patients requires providers to think beyond traditional clinical settings and address the social determinants of health. Yet integrating social services into health care can be a daunting challenge that requires a clear understanding of the target population, available resources, and an effective integration model. 

Building upon the social services integration framework shared in the HCTTF’s first webinar, Integrating Social Services into Care for the High-Need, High-Cost Population, this presentation explores models for financing integrated social service models from the perspectives of two innovative provider organizations.

View the webinar recording.

Download the slide deck.

The Transformation to Value: A Leadership Guide

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Read the reports:

Introduction

Strategy and Culture

Structure and Investments

Press Release

 

Introduction to the Dimensions of Health Care Transformation

Health care industry leaders face incredible challenges in shifting from traditional, volume-driven fee-for-service to value-based care. While the public discussion is often about specific value-based payment models, the broader transformation challenges to becoming a truly value-based organization receive much less focus. Committed organizations must often make significant changes to their strategic direction and operating structures, yet leaders don’t always have a clear precedent on how to successfully guide their organizations through these changes.

The Task Force’s Path to Transformation Advisory Group created the Dimensions of Health Care Transformation Strategic Framework (“Framework”) to assist health care leaders as they design and implement their transition to value. The Framework is built on the collective experience and wisdom from organizations that are at the vanguard of value-based payment and care delivery. It reflects introspective questions that change leaders should ask in building out an effective transformation strategy. Read our introductory report to lean more about the Framework.

Strategy and Culture

Successfully changing the culture within all levels of an organization is critical to support value-based payment and care delivery, but also one of the biggest challenges in successful transformation. Culture change involves buy-in across an entire organization (i.e., clinicians, executives, administrative staff, and affiliated partners). This requires an overarching vision for transformation, dynamic and experienced leaders, and an appropriate level of organizational integration and local leadership buy-in to successfully transition within each market. Read the report to learn more about how organizations have addressed strategy and culture change in their own transformation journeys.

Structure and Investments

Structure and investments are critical to the transformation journey because they encompass the physical infrastructure and human capital requirements needed to successfully build a value-based delivery system. Finding the right balance of resources to invest in can be extraordinarily challenging, especially for organizations that are new to value-based care. Many of the executives interviewed discussed the importance of identifying highly skilled, experienced leaders to assist with the transition process. With experienced stewardship, organizations can successfully stand up their value businesses and invest intelligently in infrastructure and resources. Read the report to learn what our leaders had to say.

Task Force Provides Input on CMS Proposed Rulemaking on CY 2018 Updates to the Quality Payment Program

The Task Force provides input on the CMS–5522–P:  Medicare Program; CY 2018 Updates to the Quality Payment Program proposed rule addressing the Merit-based Incentive Payment System and Alternate Payment Model Incentives.

Read the full input here

Read more here about our MACRA letter in Modern Healthcare

 

Task Force statement to the PTAC

As a broad-based group of 43 health care stakeholders representing patients, purchasers, payers and providers, the Health Care Transformation Task Force (HCTTF) strongly supports the transition to value-based payment and care delivery. The HCTTF supports the important work of the Physician-Focused Payment Model Technical Advisory Committee (PTAC) to advance development of additional alternate payment models in Medicare. To show support for this initiative, the HCTTF developed a statement on the PTAC which offers recommendations to make the PTAC even more effective.

Read the statement

 

State Innovation Spotlight: Implementing Multi-Payer Bundled Payment Models - Webinar & Resources

Three states – Arkansas, Tennessee, and Ohio – have implemented bundled payments for the Medicaid population to better control episode cost and quality, while aligning incentives across commercial payers to promote efficiency for participating providers. Our environmental scan of active state bundled payment models identified common episode design parameters including benchmark methodology, episode initiators, and evaluation standards across the states that have implemented bundled payments. However, each state took a unique approach to engaging providers and payers in the transformation. This webinar provided an in-depth case study of the experience in Arkansas, including lessons learned from the process of designing a multi-payer bundled payment program, and integration with other value-based payment models, the payer perspective on participating in the design of bundled payment models in Ohio.

 

View Presentation Slides

View the Webinar Recording

 

Additional Resources:

State Bundled Payment Models

State-by-state comparison of active bundled payment programs, including episode methodology and lessons learned from program implementation.

 

Task Force submits a statement for the record on the CHRONIC Care Act of 2017

The Task Force submitted a statement for the record on the recently reintroduced CHRONIC Care Act of 2017. The Task Force’s statement touches on a number of issues, such as expansion of value-based insurance design, supplemental benefits for Medicare Advantage enrollees, telehealth flexibility, voluntary ACO alignment, and lowered out-of-pocket cost burden for ACO beneficiaries.

Read the statement.

 

The Task Force provides response to CMS regarding Request for Information on Efficiencies and Flexibilities

The Task Force responded to the Request for Information included in CMS-1677-P: Fiscal Year (FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System Proposed Rule. The ability for providers to be successful in value-based payment models depends on several factors, and one key factor is the capacity to operate under a regulatory framework that is conducive to effective, efficient, patient-centered and high-quality care. The Task Force identified areas of existing Medicare regulatory structures that were designed to support a fee-for-service payment environment that focused on individual service delivery and are not ideal or necessary to support a modernized, value-based world which focuses on greater coordination and integration of care.

Read the full statement here.