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Three lessons from the Population Health Management Initiative can help accountable care organizations and health plans to build realistic approaches to value-based payment for a broader set of primary care practices.
Enthusiasm continues for value-based care models that improve population health to be adopted outside of large, integrated delivery systems. The Centers for Medicare and Medicaid Services recently announced a new Long-term Enhanced ACO Design (LEAD) Model that calls for broadening the mix of health care providers who can participate in value-based pay to include “smaller independent, or rural-based practices.” In California, the Office of Health Care Affordability has set ambitious targets for adoption of alternative payment models (APMs) by 2034 and standards to make those APMs work in an array of practice types. Additionally, the California Department of Health Care Services (DHCS) released a strategy to increase value in Medi-Cal, including increasing investments in primary care.
Kaiser Permanente (KP) is one of the nation’s largest integrated delivery systems and provides best-in-class care in part because of its unique value-based care model. In 2021, Kaiser Permanente launched the Population Health Management Initiative (PHMI) with leadership and engagement from the California DHCS. The PHMI evolved into a marquee investment to further develop the population health management capabilities of 32 community health centers (CHCs) across California and ready them for value-based payment arrangements. CHCs offer access to primary care, behavioral health, and dental services to everyone, regardless of their ability to pay, and act as a critical health care safety net in California and nationally.