20 Aug Supporting Independent Providers in Convener Relationships

HCTTF developed recommendations for the Center for Medicare & Medicaid Innovation (CMMI) to support independent providers that participate in value-based care arrangements with support from conveners. This issue brief assesses the role of conveners, examines strategic considerations for downside risk among independent providers, and offers recommendations to CMMI to ensure independent practices can drive transformational change.

Recommendations include: 

1. 1. 1. HCTTF does not believe that downside risk is always required to incentivize provider performance inside convener relationships. In the brief, we present case studies describing private-sector experience with a variety of risk arrangements between conveners and independent providers.  
      2. However, if CMMI chooses to mandate downside risk for providers, we recommend: (1) exempting small and safety net providers from risk, (2) developing tiered risk structures and caps based on practice revenue, (3) allowing conveners flexibility to develop simple downside risk mechanisms, (4) strengthen non-financial incentives for VBC participation, such as data access, exemption from reporting requirements, and access to patient cost-sharing waivers, and (5) monitoring performance to ensure conveners and the providers they support delivery high-quality patient care.   

Conveners are vital to engaging small and independent providers in VBC models. Policies must balance financial accountability with the need to sustain participation and preserve independent practice. Thoughtful financial incentives – both up and downside – can strengthen innovation while maintaining patient access and quality of care.

View the Policy Brief Here