Value-based care and population health payments have continued gaining momentum as healthcare systems and insurers look at healthcare through a new lens. These new payment reimbursements create incentives for positive patient outcomes rather than the volume of services rendered. This, in turn, requires providers to take a team-based approach to care that focuses on the whole person, not just their individual conditions.
Navigating this shifting payment environment can be overwhelming. Below you will find several resources to get you started, but the MCRH remains a resource for you and your organization.
- A summary of the Medicare Shared Savings Program changes taking effect January 2023 and 2024. This Rural Health Value analysis outlines how the changes would reduce barriers to participation for potential or reentering ACOs that operate in rural contexts.
- Updated 2023 one-page summaries describe rural-relevant, value-based programs currently or recently implemented by the Department of Health and Human Services (HHS), primarily by the Center for Medicare & Medicaid Services (CMS) and Center for Medicare & Medicaid Innovation (CMMI).
- A predominantly rural network of hospitals and clinics in Maine integrates clinical and claims data to support improvements in care delivery, and target patient needs as part of their Accountable Care Organization.
- Vermont’s dominant payers have partnered to test an alternative payment model statewide that requires healthcare organizations like MAHHC to innovate healthcare delivery and achieve shared goals. Participation in the ACO has allowed MAHHC to implement strategies to meet better community needs ranging from prevention to complex care management.
- Based on the input from a two-day virtual summit of rural participants in value-based care models and programs, the How to Design Value-Based Care Models for Rural Participant Success: A summit Findings Report summarizes themes and actionable recommendations that can be used by those designing and supporting value-based care models to improve the viability, relevance, and likelihood of rural healthcare organization participation and success.
- A critical access hospital in Susquehanna, PA, provides insight into their experience participating in the Pennsylvania Rural Health Model, which includes a global budget and transforming care to address community health needs.
- This policy brief from the RUPRI Center for Rural Health Policy Analysis summarizes non-metropolitan and metropolitan health care providers’ participation in different tracks and subdivisions in the Centers for Medicare & Medicaid Services (CMS) Quality Payment Program and evaluates provider and patient-panel characteristics associated with financial risk acceptance.
- Catalog of Value-Based Initiatives for Rural Providers, which summarizes rural-relevant, value-based programs currently or recently implemented by HHS, Primarily by CMS and CMMI.
- Rural Innovation Profile: Experiences of three rural Colorado hospitals participating in the Colorado Hospital Transformation Program (CO HTP), which aims to improve health care outcomes, equity, and access and decrease health care costs.
Social Drivers of Health Manager Contact
Laura Mispelon, MHA
Social Drivers of Health Manager
Michigan Center for Rural Health
laura.mispelon@affiliate.msu.edu