Contracting with Payers: Demonstrating the Value of Home-Based Primary Care

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Course Overview

As a home-based primary care (HBPC) provider, if you’re working in a fee-for-service (FFS) model, you bill each time you provide a service without the opportunity to be paid on quality outcomes. Therefore, the financial resources to enhance your patients’ quality of life may be limited. Value-based payment arrangements are increasingly common in the care of homebound, medically complex patients, and the prevalence of payer contracts recognizing the value of HBPC has been a game changer.

In this course, you will learn how to demonstrate the value of Home-Based Primary Care when negotiating with payers to obtain necessary funding to be more supportive of your patients’ needs and to maintain financial sustainability for your practice.

Learning Objectives

  • Upon completion, you will be able to:
    • List the various payer types relevant to home-based primary care and distinguish between the characteristics of each. Identify the key contact individuals to connect with when negotiating contracts with payers.
    • Demonstrate the value of your HBPC program to payers through presentation of patient quality, utilization and outcome data, and compelling patient stories.

Audience

This online course is intended for home-based primary care providers, as well as practice administrators, managers, and operations staff who are involved in demonstrating the value of home-based primary care to payers.

Estimated Time to Complete

30 minutes.

In order to earn credit for participation in this activity, the learner must complete a 5-question post-test with a passing score of 80% or better with unlimited attempts.

Other Information

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of PeerPoint Medical Education Institute and the Home Centered Care Institute. PeerPoint Medical Education Institute is accredited by the ACCME to provide continuing medical education for physicians.

PeerPoint Medical Education Institute designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Approved: February 20, 2024

Expiration: February 20, 2027

The following organizations accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™:

  • Physician Assistants: American Academy of Physician Assistants (AAPA)
  • Nurse Practitioners: American Academy of Nurse Practitioners Certification Program (AANPCP)
  • Nurses: American Nurses Credentialing Center (ANCC)
  • Practice Managers: Medical Group Management Association (MGMA)

None of the authors, reviewers, planners, or staff in a position to control the content of this CME activity disclosed any relevant financial relationships.

The Home Centered Care Institute gratefully acknowledges support for this activity in the form of a grant from The John A. Hartford Foundation.