Female doctor smiles at young girl

Advancing VBP

Value-based purchasing (VBP) is a strategy Health Care Authority (HCA) is using to improve the quality and value of health care services a person receives. We’re advancing VBP through:

Payment models

What’s a “payment model?”

A payment model, also called a model or alternative payment model/alternative payment methodology (APM), is a way to change how providers are reimbursed for the services they provide. Our state’s models focus on paying for quality and value of care, rather than volume.  

Health care programs

Medicaid Transformation Project (MTP)

  • Accountable Communities of Health (ACHs): MTP advances VBP through regional ACHs. Each ACH supports providers in adopting VBP and is required to develop plans to enable the success of APMs.
  • MCOs are eligible to earn MCO VBP incentives (through a “challenge pool”) for achieving annual MCO VBP targets. The amount of incentives available to an individual MCO is determined by the attributed statewide managed care members. Learn more in our Measurement Guide

Contract requirements

We’ve included VBP quality and value requirements in our Apple Health, PEBB, SEBB, and Cascade Care public option contracts.

Health equity collaboration

We’re collaborating with Community Health Plan of Washington. See our Partners page for more information on this collaborative work.

Where we’re headed

Our goal is to drive 90 percent of state-financed health care to value-based payment by the end of 2021.

View the VBP Roadmap, which outlines the road ahead for 2022-2025. The roadmap also covers our key priorities during this period, which include details on how we plan to achieve each priority. Over the next few years, we’ll be focusing on:

  • Making progress toward our 90 percent goal.
  • Promoting payment models.
  • Collaborative contracting.
  • Increasing VBP through our MTP initiatives.
  • Expanding partner and community engagement.
  • Improving health equity and addressing social determinants of health.

Contact

J.D. Fischer
VBP manager
Email:
 JD.Fischer@hca.wa.gov

Mia Nafziger
Senior health policy analyst
Email:
 Mia.Nafziger@hca.wa.gov