Value-Based Purchasing

Smarter Spending: Value-Based Purchasing under Managed Care

NC Medicaid will increasingly tie payment to value and will support PHP and provider contracting flexibility that helps providers deliver care in new ways. PHPs will play a critical role in driving forward Medicaid’s Value-Based Purchasing (VBP) goals. 

The NC VBP strategy is built upon the HCP-LAN Framework.

Policy Paper for Public Comment

NC Medicaid continues to reform Medicaid delivery and payment with the goal of improving the health of North Carolinians through an innovative, whole-person centered and well-coordinated system of care, which addresses both medical and non-medical drivers of health. 

As NC Medicaid builds on recent Medicaid transformation efforts, it is focused on how delivery reform and value-based payments for primary care and maternal and infant health can achieve this goal and improve health equity. 

NC Medicaid has published a Medicaid Delivery Reform and Value-Based Payment Market Update to seek stakeholder feedback on how to further evolve this vision. NC Medicaid welcomes feedback and input on all aspects of this market update, especially on the specific questions asked within the document related to key strategies and reforms to advance strong, coordinated, and whole-person centered primary care and maternal and infant health. 

NC Medicaid recognizes that many stakeholders have a desire to participate in actively shaping the Department’s delivery reform and payment strategies. These stakeholders include health plans, providers, people with Medicaid coverage, families and advocates, Local Health Departments (LHDs), Clinically Integrated Networks (CINs) and other partners who support provider reforms, and community-based organizations (CBOs). While timelines for new reforms and model changes will crystalize as design work progresses, the Department remains committed to engaging stakeholders as reforms are developed, and before any significant programmatic or payment changes are implemented.

We encourage stakeholders to provide feedback and respond to questions in the Medicaid Delivery Reform and Value-Based Payment Market Update by emailing Medicaid.NCEngagement@dhhs.nc.gov (subject line “VBP Feedback”) by Dec. 19, 2022.

All policy papers can be found on NC Medicaid’s Policy Papers webpage.