Value Based Payment (VBP) program – Training Coming Soon – Register Today!

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Date: May 12, 2020
To: Health Plan of San Joaquin (HPSJ) Contracted Physicians
From: Health Plan of San Joaquin
Subject: Value Based Payment (VBP) program – Training Coming Soon – Register Today!

Dear Health Plan of San Joaquin Contracted Provider,

Health Plan of San Joaquin (HPSJ) is pleased to announce that the Department of Health Care Services (DHCS) Value Based Payment (VBP) program webinar trainings will begin in the next few days.  

WHAT’S THE VBP PROGRAM?
VBP program will provide supplemental payments to providers for meeting specific measures aimed at improving care for certain high-cost or high-need populations.  Supplemental payments are for VBP measures in the following areas:

  • Behavioral Health Integration
  • Chronic Disease Management
  • Prenatal/Post-Partum Care
  • Early Childhood Prevention 

DISCLOSURE VBP PROGRAM IMPLEMENTATION

Though the state has released VBP program funding, it has not released final program guidance.  Therefore, training information and program continuance are subject to change at the sole discretion of DHCS.

THE VBP PROGRAM EXCLUSIONS

HPSJ will not be responsible for processing payment for providers NOT contracted with HPSJ.  Others not included in the program are beneficiaries with Medicare Part B, and encounters occurring at Federally Qualified health Centers (FQHCs), Rural Health Clinics, American Indian Health Clinics, and Cost Based Reimbursement Clinics.

DHCS VBP PROGRAM WEBINAR TRAINING DATES

Please register and encourage your office—e.g. medical assistance, receptionists, billers and coders—and provider team members to register for one of the following trainings via the below link information:                                                

Date Training Registration Link
May 21, 2020, 5:00 PM-6:30 PM

https://attendee.gotowebinar.com/register/4606779304793152270

May 28, 2020, 3:00 PM-4:30 PM

https://attendee.gotowebinar.com/register/8135029654954303502

June 4, 2020, 7:30 AM-9:00 AM

https://attendee.gotowebinar.com/register/612750540338811150

June 25, 2020, 9:00 AM-10:00 AM

https://attendee.gotowebinar.com/register/8496588660585800206

Note: June 25, 2020 is not a training session, but a “Follow-Up” session for obtaining DHCS VBP program clarification based on the HPSJ most recent guidance from DHCS. Registration links also available on our DHCS VBP webpage:  https://www.hpsj.com/valuebasedpayments/

DHCS VBP TRAINING TOPICS (partial list): About the DHCS Value Based Payments Program, In-Depth VBP
Measure Review, Critical DHCS VBP Program Disclosures, Correct Claims, Registry Use, Program Exclusions, Program Inclusions, Frequently Asked Questions  

WHAT’S NEXT?
If you are unable to participate one of the webinar trainings, please call HPSJ Customer Service at 209.942.6340 to set up a training with an HPSJ Provider Services Representative, Monday – Friday, 8:00AM to 5:00PM.  For your convenience attached is a summary of VBP measures that will be discussed during your training.  We value you as a provider and look forward to ensuring your successful program participation.  Health Plan of San Joaquin is dedicated to providing all members the best health care available in the most effective and efficient manner. Thank you for being one of our valued partners and your continued support of Health Plan of San Joaquin.

PROPOSED DHCS VALUE BASED PAYMENTS PROGRAM MEASURES & REIMBSUREMENTS

Domain

Measure

Add-On Amount

At-Risk
Add-On Amount

Prenatal/Postpartum Care Bundle

Prenatal Pertussis
(‘Whooping Cough’)
Vaccine

$         25.00

$         37.50

Prenatal/Postpartum Care Bundle

Prenatal Care Visit

$         70.00

$       105.00

Prenatal/Postpartum Care Bundle

Postpartum Care (Early or Late) Visits

$         70.00

$       105.00

Prenatal/Postpartum Care Bundle

Postpartum Birth Control

$         25.00

$         37.50

Early Childhood Bundle

Well Child Visits in First 15 Months of Life

$         70.00

$       105.00

Early Childhood Bundle

Well Child Visits in 3rd – 6th Years of Life

$         70.00

$       105.00

Early Childhood Bundle

All Childhood Vaccines for Two Year Olds

$         25.00

$         37.50

Early Childhood Bundle

Blood Lead Screening

$         25.00

$         37.50

Early Childhood Bundle

Dental Fluoride Varnish

$         25.00

$         37.50

Chronic Disease Management Bundle

Controlling High Blood Pressure

$         40.00

$         60.00

Chronic Disease Management Bundle

Diabetes Care

$         80.00

$       120.00

Chronic Disease Management Bundle

Control of Persistent
Asthma

$         40.00

$         60.00

Chronic Disease Management Bundle

Tobacco Use Screening

$         25.00

$         37.50

Chronic Disease Management Bundle

Adult Influenza (‘Flu’) Vaccine

$         25.00

$         37.50

Behavioral Health Integration Bundle

Screening for Clinical Depression

$         50.00

$         75.00

Behavioral Health Integration Bundle

Management of
Depression Medication

$         40.00

$         60.00

Behavioral Health Integration Bundle

Screening for Unhealthy Alcohol Use

$         50.00

$         75.00

Posted on May 12th, 2020

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