This measure is important because it shows the range, scale, and impact of DVHA’s value-based care initiatives.
The DVHA Payment Reform Unit is engaged in a number of projects designed to address the triple aim of reducing growth in health care costs, improving care, and improving the health of the population. Projects include the Vermont Medicaid Next Generation (VMNG) Accountable Care Organization (ACO) program (featuring all-inclusive population based payments), the Adult and Children's Mental Health project (a case rate model), the Residential Substance Use Disorder project (episodic payments), the Applied Behavior Analysis autism benefit project (monthly bundled payments), the Brattleboro Retreat (inpatient per diem payments), High-Technology Nursing (a hybrid monthly and FFS payment), and the Children’s Integrated Services project (prospective monthly bundled payments).
The data presents two views of the information:
- A count of Medicaid members impacted by payment reform. Members may be impacted by more than one project so there may be some duplication. Historically, duplication has been in the 3-4% data range.
- The numbers of Medicaid members impacted by each project
Variables impacting this measure over time include provider participation in payment reform initiatives, Medicaid member access to participating providers, and the development and implementation of new payment reform programs.
The trendline has held steady after a sharp increase in January 2020 and again in January 2022. Attribution to the VMNG program is the biggest driver of results for this measure. Attribution for that program occurs in January of each year; between extensive provider participation and the implementation of an innovative statewide expanded attribution initiative (see “Strategy” section below), impact may be close to the maximum achievable level.
Narrative last updated: 06/15/2022