Winning on Total Cost of Care to Achieve VBP Success

Much has transpired over the past year since CMS approved an amendment to New York’s Medicaid 1115 Waiver, allowing the state to make large investments (approximately $6.8 billion in funding over the next three years) across a series of wide-ranging Medicaid initiatives.

The Downstate global hospital budget component is now on solid footing with the new administration announcing that it will move forward with the AHEAD global budget model, upon which New York’s Medicaid global budget model will be based. This includes the option to coordinate a Medicare Shared Savings ACO with AHEAD.

Dr. Oz is also now formally seated as the CMS administrator and he is signaling a focus on value based payment as a way to both improve quality and control costs.

During this event, we’ll discuss the evolving regulatory landscape; the state of the NY Global Budget process; considerations for hospitals, community IPAs and health plans; and the transformation requirements for safety net hospitals entering into global budgets to be successful, as well as the requirements more generally for success in value based payment for all payers and providers.

Featured Speakers