Value-Based Purchasing Programs Designed to Deliver Better Outcomes

Get the specialized consulting, analytics services, software solutions, and comprehensive support you need to improve outcomes and lower costs. As a trusted state government and payer partner, we can help you accelerate value-based care innovations to transform payment and healthcare delivery. 

Data Aggregator

Analytics Provider

Software Supplier

Accelerate Your Value-Based Care Program

State Medicaid agencies and health plans work with us as a data intermediary and trusted partner to design, implement, operate, and evaluate value-based care programs that align with their quality strategies. We help states develop programs for their delivery systems that focus on their areas of priority, target provider settings and beneficiary populations of interest, and include a comprehensive array of measures leveraging diverse data sources.  

Providers

“The Health Care Quality Surcharge (HCQS) was implemented with the aim of improving the quality of care for long-term care residents and clients, and quality measure data indicates that the HCQS has been successful in achieving its goal.” 


Vicente Vargas, Executive Director
New Mexico Health Care Association and the New Mexico Center for Assisted Living 

Facility Owners & operators

“We are so thankful to the state of New Mexico for this program. It enabled us to invest in our facilities and we were able to turn our troubled facilities into top performers.” 


Jill Matthews, Director of Reimbursement and Revenue Integrity 
Heritage Management Services 

medicaid beneficiaries & the state

“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)

MCOs

“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 

Drive Performance Improvements With Actionable Insights

Use actionable insights to make informed decisions and achieve improvements in care quality and outcomes. Net Health’s subject matter experts can provide comprehensive advice on value-based care program development, as well as necessary State Plan Amendment and rule-making/statutory changes.

Analytics Services

  • Data diligence, validation, and analyses
  • Measure development and selection
  • Baselines and benchmarking
  • Performance assessment and payment methodologies
  • Models and “what if” scenarios to support decision-making

Reporting and Software Solutions

  • Data management and aggregation
  • Robust reporting and data exports
  • Software-as-a-service solutions for payers and providers:
    • Value-based purchasing (VBP) pay for performance (P4P) scorecards
    • Provider quality improvement solutions
    • Patient care management solutions

Comprehensive and Ongoing Support

  • Deep subject matter expertise in provider, payer, and state government for trusted advisership
  • Consultative and collaborative approach
  • World class user support
  • Federal and state regulatory/legislative support
  • Stakeholder facilitation

CASE STUDY

Proven Operational and Clinical Results for States and Payers

For our clients in New Mexico, key stakeholders are actively engaged and aligned, providers attribute improvements in quality and operational outcomes to the programs, and there has been meaningful and sustained improvement in clinical and utilization measures.

Net Health’s two New Mexico nursing facility Medicaid VBP programs were designated as fully or highly aligned with best practices in the Center for Health Policy Evaluation of Long-Term Care (CPHE) study, A Review of Nursing Home Medicaid Value-Based Payment Programs (February 2022). Only four of the 30 programs across 24 states received this designation.

Measurable Quality Improvement In New Mexico Nursing Facilities

  • Improvement in long-stay hospitalization and pressure ulcers
  • Some individual facilities have significantly improved in multiple quality areas

Provider Support and High Levels of Satisfaction

  • Supported repeal of the provider surcharge sunset and continuation of both VBP programs
  • Provider testimonials
  • NPS score with best-in-class performance

Get Started Today

For more information on Value Based Care Solutions for States and Payers, please fill our the form.

"*" indicates required fields