In Case You Missed It: DHHS Presents VBP Explanation

• By: Ben Hawkins
• On: 02/20/2025 16:49:47
• In: Legislative/Government Affairs

Earlier this week, the Maine Department of Health and Human Services (DHHS) held an important session on Making Sense of Value-Based Purchasing (VBP) to help providers and stakeholders better understand the state's transition toward a more outcomes-driven payment system. If you missed the presentation, here are the key takeaways: VBP is a payment model that ties reimbursement to quality and outcomes rather than just the volume of services provided. MaineCare is implementing VBP to try to:

• Improve health outcomes for Maine residents.
• Promote cost efficiency in healthcare spending.
• Align payment structures with evidence-based practices.
• Encourage provider accountability and care coordination.

The presentation outlined several core elements of Maine's VBP approach, including:

1. Alternative Payment Models (APMs) – Replacing traditional fee-for-service models with risk-sharing agreements.
2. Quality Metrics & Performance Incentives – Providers will be rewarded for meeting specific quality benchmarks.
3. Focus on Equity – Addressing disparities in healthcare access and outcomes.
4. Provider Readiness & Support – DHHS is working to ensure providers have the tools needed to transition successfully.
5. Quest Partnership – A collaborative initiative supporting facilities with training, technical assistance, and quality improvement strategies.

• Providers will see a shift from volume-based payments to performance-based incentives.
• Data reporting and analysis will play a crucial role in reimbursement.
• MaineCare will offer technical assistance to help providers adapt.
• Quality Champions will need to be designated at each nursing facility to lead participation in the Quest Partnership.
• Facilities must contract with a CoreQ vendor for resident and family satisfaction surveys.
• Providers will need to meet with Maine's Health Information Exchange (HIE) to explore data integration opportunities.

The Quest Partnership was introduced to assist providers in adapting to VBP. Quest stands for Quality, Excellence, Staffing, and Teamwork and includes:

• Monthly educational calls covering different aspects of VBP.
• Dementia Care Partnership – An initiative to reduce the use of antipsychotic medications in long-term care.
• Culture Change Coalition – A focus on improving staffing stability and reducing turnover through best practices.
• Technical Assistance & Reports – Providers will receive quarterly performance reports to track progress.

To share in the $8.1 million quality bonus pool, nursing facilities must:

1. Identify and register a Quality Champion who will lead internal efforts.
2. Participate in the Quest Partnership calls and initiatives.
3. Contract with a CoreQ vendor to conduct resident and family surveys.
4. Meet with Maine's Health Information Exchange (HIE) to explore opportunities for data reporting and integration.

• Review the full DHHS presentation slides linked here and video linked here.
• Assess your organization's current data collection and reporting capabilities.
• Stay tuned for upcoming stakeholder engagement opportunities.
• Ensure your facility is on track to meet the participation requirements by the October 1, 2025, deadline.

MHCA will continue to track these changes and advocate for our members throughout the VBP transition. If you have questions or concerns, feel free to reach out.

Staff contact: bhawkins@mehca.org