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Value-Based Payment for Home and Community-Based Services

Technical Assistance

Efforts to incentivize quality and outcomes have been utilized more for acute care than for home and community-based services (HCBS), except in states that have incorporated quality measures in their payment methodologies for nursing facilities. Therefore, IAP built the knowledge base and capacity of Medicaid agencies to begin increasing their adoption of strategies that tie together quality, cost, and outcomes in support of community-based LTSS through one-on-one technical support focused on designing and implementing value-based payment (VBP) strategies for HCBS.

  • Planning a VBP HCBS Strategy: This track, which began in April 2016 and ran for a six month period, provided Indiana, Maryland, Mississippi, North Carolina, Nebraska, Nevada, Ohio, Pennsylvania, and Virginia with strategic planning support in developing an VBP approach for community-based LTSS.
  • Implementation of a VBP HCBS Strategy: This track, which began in September 2016 and ran for a six month period, provided support to Massachusetts, New Jersey, Virginia, and Washington with the early stages of their implementation activities. Learn more about the participating states and their IAP work (PDF, 80.36 KB).
  • Designing a VBP HCBS strategy: This track, which began in May 2018 and ran for a 12 month period, provided support to Hawaii, Indiana, Kentucky, Louisiana, Minnesota, Missouri, New Jersey, Ohio, Texas, and Washington with designing a VBP HCBS strategy and moving states toward implementation. Learn more about the participating states and their IAP work (PDF, 102.75 KB).
  • Value-Based Payment for Fee-for-Service Home and Community-Based Services Technical Assistance: IAP provided technical assistance to Medicaid agencies in California, Indiana, Maryland, and Maine to improve HCBS options for individuals receiving LTSS. This had a special focus on shared savings and non-financial incentives in addition to pay-for-performance and quality incentive payment models. Learn more about the participating states and their IAP work (PDF, 168.14 KB).

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