Value-based purchasing update: 2023 VBP measures selection
Our goal is to achieve a healthier Washington by containing health care costs while improving outcomes, patient and provider experience, and equity. One way we can reach this goal is through value-based purchasing (VBP).
About VBP
VBP is a strategy used to improve the quality and value of health care services a person receives. VBP supports health plans and health care providers to be financially incentivized for providing high-quality, high-value care and a satisfying patient experience.
VBP uses value-based payment, which is a payment method for providers that rewards providers for the quality of health care, rather than the volume or number of patients a provider sees.
2023 VBP measure selection
Part of our VBP work includes selecting the VBP quality performance measures within the 2023 Medicaid managed care contracts. Performance measures are a tool managed care organizations use to monitor the health of their enrollees. The Legislature and HCA’s Quality Measurement and Monitoring Improvement program guide which measures HCA selects for these contracts.
HCA partnered with Comagine Health, the contracted external quality review organization, to conduct a review of the current performance measure results. After our review, we determined that we’ll make minimal changes to the current set of VBP measures for the 2023 contract year.
Here’s the integrated managed care and integrated foster care contract measures for next year:
2023 integrated managed care measures
- Antidepressant Medication Management (AMM) – Acute & Continuation Phases
- Asthma Medication Ratio (AMR) – Total
- Child and Adolescent Well-Child Visits (WCV) – 3-11 years
- Follow-Up Care for Children Prescribed ADHD Medication (ADD) – Initiation
- Prenatal and Postpartum Care (PPC) – Timeliness of Prenatal Care & Postpartum Care
- Substance Use Disorder (SUD) Treatment Rate (previously known as SUD Treatment Penetration)
- Breast Cancer Screening (BCS-E, Electronic Clinical Data Systems measure) – new
We’ve selected the following measures to incentivize performance outside of VBP:
- Childhood Immunizations, Combo 10 (CIS)
- Follow-up After Hospitalization for Mental Illness (FUH) – 30-day – new
2023 integrated foster care measures
- Asthma Medication Ratio (AMR) - 5-11 and 12-18 years
- Child and Adolescent Well-Child Visits (WCV)
- Follow-Up Care for Children Prescribed ADHD Medication (ADD) – Initiation
- Mental Health Treatment Rate (previously known as Mental Health Treatment Penetration)
- SUD Treatment Rate (previously known as SUD Treatment Penetration)
- Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)
For questions, please contact Carey Wallace.
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