Last week, I had the privilege of participating in the National Association of Community Health Center’s (NACHC’s) 4^th annual Payment Reform Summit.  This one-day event brought together Primary Care Associations (PCAs), Health Center Controlled

Russ Dexter, Chief Innovative Officer

Networks (HCCNs), and health centers from across the country to engage in discussions about payment reform and efforts underway to prepare health centers for a likely change in reimbursement methodology. Across the whole health care spectrum, national and state-level discussions are ongoing about switching from a system that reimburses on a per-visit basis (“volume”) to one that reimburses at least partially based on health outcomes and other metrics (“value”).  There were four overarching topics at the Summit:

1. Formal care teams that can address Social Determinants of Health (SDOH) and other needs of specific populations are the foundation for being successful under value-based payment models.
2. Coding must properly document the diagnosis and care that is being provided.   Doing so is critical to document the complex needs of patients being served, as well as to improve scores on performance metrics.
3. Health centers must be willing to work together under performance models such as Independent Practice Associations (IPAs).
4. It all starts with data.  The ability to capture, validate, and respond to data is necessary for effective population management and quality improvement.

The highlight for me was hearing from health centers on the strategies and interventions they are already implementing to operate under existing value-based payment models. My takeaway was that our member health centers are leveraging the resources available through CT-PTN to position themselves well for payment reform and, in many cases, are outperforming their peers in other states. I look forward to continued conversations, involving health center staff and leaders, as well as policymakers.

Russ