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From Volume to Value, With Care
A curated selection of resources to help you thrive in a value-based care environment.
Welcome to the Care Partners Resource Site, your destination for mastering value-based care. Here, you’ll find a curated collection of resources designed to support healthcare professionals in delivering exceptional patient care while navigating the intricacies of various care models. From in-depth explorations of specific programs like MSSP, MA, and Commercial Insurance, to specialized materials on Risk Adjustment and CAHPS, and Best Practices for clinical excellence — the library is rich with insights. Each resource, whether it’s a detailed toolkit, an engaging presentation, or a succinct tip sheet, is crafted to empower you with the knowledge and tools necessary for thriving in the evolving landscape of healthcare.
MSSP
The Medicare Shared Savings Program (MSSP) is a key CMS initiative aimed at fostering collaboration among healthcare providers. The goal? To improve patient care while reducing unnecessary costs. Whether you’re new to MSSP or looking to enhance your participation, you’ll find everything you need right here. From comprehensive toolkits perfect for desk reference to targeted learning presentations and tip sheets, we’ve got you covered.
- 2024 DM-2 Diabetes: Hemoglobin A1c Poor Control >9%
- 2024 PREV-5 Breast Cancer Screening
- 2024 CARE-2 Falls: Screening for Future Fall Risk
- 2024 HTN-2 Controlling High Blood Pressure
- 2024 MH-1 Depression Remission at Twelve Months
- 2024 PREV-6 Colorectal Cancer Screening
- 2024 PREV-7 Influenza Immunization
- 2024 PREV-10 Tobacco Use: Screening and Cessation Intervention
- 2024 PREV-12 Depression Screening and Follow Up
- 2024 PREV-13 Statin Therapy for the Prevention and Treatment of CVD
- CARE-2: Falls: Screening for Future Fall Risk
- DM-2: Diabetes: Hemoglobin A1C Poor Control >9
- HTN-2: Controlling High Blood Pressure
- MH-1: Depression Remission at Twelve Months
- PREV-5: Breast Cancer Screening
- Colorectal Cancer Screening
- PREV-7: Preventive Care and Screening: Influenza Immunization
- PREV-10: Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
- PREV-12: Preventive Care and Screening: Screening for Depression and Follow-Up Plan
- PREV-13: Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
Medicare Advantage
Medicare Advantage (MA) is a program that offers Medicare benefits through private-sector health plans. While health plans may have varying program criteria, this section is tailored for those committed to delivering quality care while navigating the unique aspects of MA using the standard NCQA and PQA program specifications. Here, you’ll discover an array of resources to guide your practice, including detailed toolkits for quick reference, engaging presentations for deeper learning, and concise tip sheets for on-the-go insights.
- 2024 BCS-E Breast Cancer Screening
- 2024 CBP Controlling High Blood Pressure
- 2024 COA-Med Review Care for Older Adults, Med Review
- 2024 COA-Pain Care for Older Adults, Pain
- 2024 EED Eye Exam for Patients with Diabetes
- 2024 FMC Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions
- 2024 KED Kidney Health Evaluation for Patients with Diabetes
- 2024 OMW Osteoporosis Management in Women with a Fracture
- 2024 PCR Plan All Cause Readmission
- Statin Therapy for Patients with Cardiovascular Disease (SPC)_2024
- Transitions of Care(TRC)_2024
- Adult Immunization Status (AIS-E) 2024
- Breast Cancer Screening (BCS-E) 2024
- Controlling High Blood Pressure (CBP) 2024
- Care for Older Adults (COA): Functional Status Assessment 2024
- Care for Older Adults (COA): Medication Review 2024
- Care for Older Adults (COA): Pain Assessment 2024
- Eye Exam for Patients with Diabetes (EED) 2024
- Follow-Up After Emergency Department Visit for People With Multiple High-Risk Chronic Conditions (FMC) 2024
- Kidney Health Evaluation for Patients with Diabetes (KED) 2024
- Medication Adherence for Cholesterol (MAC) 2024
- Medication Adherence for Diabetes (MAD) 2024
- Medication Adherence for Hypertension (MAH) 2024
- Osteoporosis Management in Women with a Fracture (OMW) 2024
- Statin Therapy for Patients with Cardiovascular Disease (SPC) 2024
- Statin Use in Persons with Diabetes (SUPD) 2024
- Transitions of Care (TRC) – Medication Reconciliation Post-Discharge 2024
- Transitions of Care (TRC) – Patient Engagement After Inpatient Discharge 2024
- Medication Therapy Management Program Completion Rate for Comprehensive Medication Review 2024
- Plan All-Cause Readmissions 2024
Commercial Programs
The landscape of Commercial value-based care programs is dynamic as health plans work to innovate around patient care. These programs often involve agreements with private insurers to provide high-quality, cost-effective care. This section serves as your one-stop resource for mastering these complex arrangements. From all-encompassing toolkits that serve as your desk-side companion to succinct presentations and tip sheets for specific insights, we have meticulously curated these materials to support your success in commercial healthcare markets. Where materials are health plan specific, we have added that health plan name to make them easier to identify.
- 2024 Value-Based Care Program for Primary Care for Commercial Line of Business: Anthem Commercial Program
- 2024 Commercial Measures At-A-Glance – Anthem
- 2024 AMR Asthma Medication Ratio
- 2024 BCS-E Breast Cancer Screening
- 2024 Brand Formulary Compliance Elevance Utilization Measure
- 2024 CIS Childhood Immunization Status
- 2024 COL Colorectal Cancer Screening
- 2024 EDU Emergency Department Utilization
- 2024 FUM Follow-Up After Emergency Department Visit for Mental Illness
- 2024 KED Kidney Health Evaluation for Patients with Diabetes
- 2024 PCR Plan All Cause Readmission
- 2024 Potentially Avoidable Pediatric Emergency Room Visits Elevance Utilization Measure
- 2024 W30 Well-Child Visits in the First 30 Months of Life
- 2024 WCV Child and Adolescent Well-Care Visits
- Asthma Medication Ratio (AMR)
- Breast Cancer Screening (BCS-E)
- Brand Formulary Compliance Rate
- Childhood Immunization Status
- Colorectal Cancer Screening (COL-E)
- Emergency Department Utilization (EDU)
- Follow-Up After Emergency Department Visit for Mental Illness (FUM)
- Kidney Health Evaluation for Patients with Diabetes (KED)
- Medication Adherence for Cholesterol (MAC)
- Medication Adherence for Hypertension (MAH)
- Plan All-Cause Readmissions
- Potentially Avoidable Pediatric Emergency Room Visits
- Well-Child Visits in the First 30 Months of Life (W30)
- Child and Adolescent Well-Care Visits (WCV)
Risk and Diagnosis Coding
Welcome to the Risk Adjustment resource center, a dedicated space for understanding and optimizing your approach to condition-specific care across all value-based programs. Risk Adjustment plays a crucial role in ensuring healthcare providers are appropriately compensated for the complexity and severity of patients’ conditions. Here, you’ll find targeted materials designed to enhance your knowledge and application of Risk Adjustment strategies. These resources were crafted to support your efforts in delivering high-quality, personalized care.
- Risk Adjustment Live Session Calendar
- 2024 Risk Adjustment Pocket Guide
- ACA Coding Toolkit
- Risk Adjustment 101
- Introduction to Risk Adjustment: Medicare Advantage Value Based Care
- Coding Severe Obesity
- Coding Depression and Related Mental Health Disorders
- Coding Respiratory Conditions
- Coding Heart Failure
Patient Experience: Health Plan Survey (CAHPS)
Consumer Assessment of Healthcare Providers and Systems (CAHPS) is a pivotal tool for measuring patient satisfaction and experience within healthcare settings. Understanding and improving CAHPS scores is essential for enhancing patient care, boosting reputation, and succeeding in value-based care programs. In this section, we offer a collection of resources designed to help you and your team excel in delivering patient-centered care.
Best Practice Resources
This section is dedicated to bringing you the latest and most effective strategies for delivering superior healthcare, starting with our current focus on blood pressure re-checks. These practices are pathways to enhancing patient outcomes, ensuring safety, and optimizing overall care delivery. As we expand this section, expect to find a wide array of curated materials designed to support your continuous improvement and leadership in healthcare.
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