How is the development of Regional Accountable Care Communities (ACCs) being supported by Virginia’s State Innovation Model (SIM) grant?
Over the SIM grant period (February 2015 – January 2016) the SIM staff team is convening regional stakeholders within Virginia’s five health planning regions to:
- Provide updates to stakeholders on the status and outcomes of the SIM planning groups.
- Learn from regional partners what projects and initiatives are already underway that align with the “Key Improvement Areas” identified by the Lt. Governor’s Roundtable on Quality, Payment and HIT. These projects will be included in the ACC Asset Inventory so that funding opportunities identified by VCHI can be readily matched with potential partners and projects.
- Begin to identify partners within each region that are interested in forming an ACC with further guidance from VCHI in 2016 and beyond.
How does the Delivery Reform Incentive Payment Program (DSRIP) waiver proposed by the Department of Medical Assistance Services (DMAS) support ACC development?
There is not a formal, direct relationship between DSRIP and ACCs. If Virginia successfully obtains a DSRIP waiver, the funding will support providers in preparing them to successfully implement DSRIP projects that serve the Medicaid population and align with the priorities outlined by DMAS. As proposed by DMAS, this would be accomplished through the formation of groups of “Virginia Integration Partners” (see more below). ACC priorities that fall outside of the scope of DSRIP will be addressed via cross-organizational collaborations and/or other outside funding sources.
What are Virginia Integration Partners (VIPs)?
- Coalitions of providers interested in forming contractual partnerships to serve the Medicaid population.
- Public and Private interdisciplinary partnership of providers focused on care coordination and integrated service delivery.
- Partnership may include (but are not limited to) social workers, medical care and behavioral health providers, school-based providers, FQHCs, and long-term services and support providers.
VIPs Will Each Have a Coordinating Entity:
- The coordinating entity will serve in a leadership role across the partnership.
- The coordinating entity will contract with DMAS for DSRIP funding (infrastructure, support, etc.)
- The coordinating entity will contract with Medicaid-contracted managed care plans for payment of services.
How are VIPs different from ACCs?
First, ACCs likely cover a much larger geographic area than VIPs. An ACC will serve as a regional organizing structure and ACC partners may select multiple projects and/or populations to target based on the needs of the region. Specific design and model elements of the VIPs are still underway. VIPs will have a specific focus on serving the Medicaid population and will likely serve a smaller geographic area. There may be multiple VIPs within an ACC, or there may be VIPs that are not part of an ACC.
It should also be noted that VIPs and ACCs are not mutually exclusive to one another, i.e. a VIP does not have to be part of an ACC nor does an ACC have to have one or multiple VIPs. ACCs could implement innovative projects or create formal cross-organizational relationships through multiple funding sources outside of DSRIP.