Hello CHPA Community,
Have you ever experienced a new person, place, or thing and then suddenly it seems like it is everywhere? For example, when you are shopping for a vehicle and decide on a color, and then that color seems to be much more prevalent on the road. This phenomenon is known as “Red Car Syndrome” or the “Baader-Meinhof Effect” and there are a few psychological processes contributing to it. The first, selective attention, kicks in when you’re struck by a new word, thing, or idea; after that, you unconsciously keep an eye out for it, and as a result find it surprisingly often. The second, confirmation bias, reassures you that each sighting is further proof of your impression that the thing has gained overnight omnipresence.
I have had the privilege of serving as the Interim CEO of CHPA for about five months now. Admittedly, I am living and breathing Value-Based Care (VBC) more than ever in my career. However, I am convinced that value-based care is a critical success factor for healthcare’s future, and it is much more than Red Car Syndrome. While there is still plenty that isn’t working well in our healthcare system, VBC models have been at the core of improvement efforts for decades and are a source of hope moving forward.
There is plenty of evidence from macro and micro levels. First of all, at the federal level, there are more patients than ever aligned to ACOs in 2023. There are now 456 ACOs in the Medicare Shared Savings Program, the country’s dominant value-based payment program, while the ACO Realizing Equity, Access, and Community Health (REACH) Model counts 132 participants. The two programs combine to serve 13 million Medicare beneficiaries. The Centers for Medicare & Medicaid Services (CMS) have stated their intent that all Medicare fee-for-service beneficiaries will be in a care relationship with accountability for quality and total cost of care by 2030 and that the vast majority of Medicaid beneficiaries will be as well.
At the state level, please note the CMS Map and Website, which visualizes where there are concentrations of innovation models, many of which are directly or indirectly related to VBC. An image from the website is below, and you can see how Colorado stands out as a leader in this area. While not all of this is specific to Community Health Centers (CHCs), a lot of credit and gratitude is due to the Colorado Community Health Network (CCHN) and veterans of the CHC movement in Colorado, past and present, for advancing these models.
Here at CHPA, we are having regular conversations with new and existing payers to move forward in the continuum from fee for service, to pay for performance, and VBC contracts. We are also seeing connections between the work we do and how that parallels with the goals of the Colorado Department of Healthcare Policy and Financing (HCPF) and their Accountable Care Collaborative as that program moves into the third phase.
In the end, as we continue to capture the incredible value our members are contributing to patients and the healthcare delivery system, we are optimistic that it will result in more diversified revenue for the CHCs. Those funds will not only enhance financial sustainability, but they also enable more investment into the CHC’s mission of access and quality care for all. It is like a flywheel and even though it takes a lot of effort to get it moving, once momentum starts it will eventually become enough of a force to make our healthcare system work better for more people.
Thank you for your dedication and partnership,