Value-Based Care Solutions for States and Payers

A True End-to-End Partner for Value-Based Care Programs

Everything you need for a successful value-based payment program combining analytics, technology, and ongoing support with value-based care policy expertise ​

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Nearly a decade of proven success with effective statewide value-based payment programs​

Transforming Healthcare Delivery and Payment ​

Achieve better value for Medicaid funds spent on care​

Increase provider participation and risk-sharing in VBP models​

Ensure program integrity and prevent fraud, waste & abuse​

Support whole-person care and improve population health​

Why State Medicaid Agencies Work with Net Health​

  • Operationalize value-based care at scale​
  • Create consistency across MCOs and provider types​
  • Embed quality strategy priorities directly into payment models​
  • Deliver demonstrable improvements in outcomes and total cost of care
  • Design CMS-aligned VBP and alternative payment models
  • Align payment, quality, and oversight infrastructure​
  • Ensure audit-ready compliance and reporting
  • Comprehensive data aggregation and management​
  • Unified analytics and transparent dashboards​
  • Real-time provider eligibility and performance solutions​
  • Digital member experience and survey capture​
  • Predictive analytics for proactive care management
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Proven Success in New Mexico​

Since 2019, quality-based incentive programs have driven measurable and sustained improvement in quality outcomes and utilization. ​

New Mexico’s Nursing Facility long-stay hospitalization rate is significantly lower than the national average.

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The hospital program was expanded to specialty facilities and impacts include implementation of screening for substance use disorder and referrals to treatment in EDs, improvements in behavioral health care coordination, and sustained improvements in sepsis care.

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Launched in 2024, New Mexico’s Primary Care Payment Reform (PCPR) program is one of the nation’s few fully statewide Medicaid value-based payment models for primary care.
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Designed to perform across diverse providers and communities with an initial focus on access to care, utilization, and patient experience, the program is showing strong early results​.
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“The data clearly demonstrates this investment is producing viable results in providing better quality care and improved health outcomes for our most vulnerable New Mexicans. ”

Kari Armijo, Cabinet Secretary, New Mexico Human Services Department (HSD)​

“Net Health’s knowledge of nursing facility data, nursing facility quality measures, and ability to collect MDSs has been instrumental to the success of the project. Their software tools are easy to use with meaningful data and analytics—both at the aggregate level and down to the facility and member level.” 

Tim Voskuil, Performance and Results Consultant, Network Services, Blue Cross and Blue Shield of New Mexico ​

The Highest Level of Cybersecurity​

Net Health takes the utmost care to properly secure and protect customer data through policy implementation, robust technical controls and external compliance assessments.

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You’ve got questions. We’ve got answers.​

Value-based care is a delivery model that rewards high-quality, patient-centered outcomes rather than volume. Within Medicaid, value-based care strengthens whole-person care by aligning payment incentives with improvements in access, equity, and quality. When states adopt value-based care frameworks, providers gain clear expectations, actionable data, and the structure needed to advance population health across diverse care settings.​

Value-based payment (VBP) links reimbursement to measurable performance – such as reducing avoidable hospitalizations, higher patient experience scores, or stronger care-coordination practices. A statewide VBP payment framework creates consistent metrics, reduces variation and blind spots created by plan-by-plan contracts, and provides unified visibility into provider performance. This enhances accountability and aligns all stakeholders around the state’s quality strategy.​

Whole-person care requires addressing clinical, behavioral, and social needs in a coordinated, proactive way. Net Health’s statewide VBP programs incorporate predictive analytics, patient experience tools, and real-time data that help providers identify high-risk individuals and intervene earlier. These capabilities support more comprehensive, whole-person care approaches that improve outcomes and experience while advancing broader population health goals.​

Statewide value-based care and value-based payment structures create a unified platform for identifying quality variation, monitoring trends, and scaling interventions across entire populations. By standardizing measures and incentives, states can more effectively promote preventive care, reduce unnecessary utilization, and drive measurable population health improvements.​

Statewide VBP programs establish a single framework, consistent quality measures, and unified incentives applied across all Medicaid managed care organizations and providers. Unlike MCO-specific value-based contracts — which vary plan to plan and create fragmentation — statewide programs eliminate blind spots, reduce administrative burden, and give states full visibility into provider performance and improvement opportunities. These statewide programs supplement, rather than replace, MCO-provider value-based contracts by providing centralized data, standardized expectations, and alignment with CMS priorities, ultimately strengthening both the managed care environment and statewide population health outcomes.​

Implementing statewide VBP programs requires expertise across program design, analytics, technology, and operations. Net Health is the premier partner that designs, builds, implements, and operates statewide Medicaid VBP programs across provider types. Our unified model integrates data aggregation, risk adjustment, real-time dashboards, provider onboarding tools, and patient experience solutions combined with white glove service and support, giving states a single, trusted source of truth with proven results.​

Better outcomes. Better value.

Net Health can help you transform healthcare delivery and payment.​

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