How to Use This Checklist:
This is a supplement to our Module 2: The Managed Care Data Set, which uses the HCP-LAN APM Framework as its basis. Review both before using this checklist. There are terms used throughout that may be new to you or may benefit from detailed explanations—please visit our Value Based Payment Glossary for basic definitions for a host of key terms.

This checklist will walk you, the health center, through a series of common considerations for contracts you may receive from payers with a specific focus on contracts that include value-based payment components. This document assists organizations in understanding the necessary data and data-related tools for managing population health within a managed care environment. It is a primer on the types of best-practices that are necessary to maximize care delivery models that are responsive to value-based payment programs. Follow this checklist to further your understanding of these considerations and to help flag any outstanding issues for legal and/or consultant review prior to execution.

It is important to understand, contracts can be complicated and no one tool can effectively address all possible contract configurations and their potential issues. Use this as a guide with other resources, access outside expertise when needed, and apply your own knowledge and understanding of your business. It also never hurts to ask the health plan representatives if something is not clearly understood.

In recent years, health centers have become increasingly interested in and charged with not only addressing the health concerns of their patients, but centering and responding to patient’s social needs. According to Healthy People 2030, social needs, also known as the social determinants of health, are the conditions in the environments where people live, learn, work, and play that affect a wide range of health, functioning, and quality-of-life outcomes and risks. Social needs encompass the quality of and access to resources such as housing, transportation, safety, employment, food, and more. Identifying and addressing unmet social needs as part of the clinical encounter provides the opportunity to deliver higher-quality, whole-person care, advance population health, and reduce healthcare costs.

When implementing a social need screening program, it can be challenging to identify how frequently to conduct the screening with patients. Health centers may have to explore various strategies to develop a workflow that prevents appointment backups and reduces the burden on staff. This resource shares examples of strategies gleaned from interviews with health centers.

Implementing a social need screening effectively is an iterative process. Many health centers find that their approach evolves as new concerns or considerations arise. The examples in this resource, gleaned from interviews with health centers, illustrate that unique context and needs drive what works.

Establishing a social need screening program requires buy-in from both leadership and staff. This resource shares examples of strategies gleaned from interviews with health centers.

In this video, viewers will learn how People, Process and Technology should factor into a health center's social needs screening workflow

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series will present health center case examples that explore the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encourage participants to discuss the implications for health centers and their patients. 

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series presented health center case examples that explore the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encourage participants to discuss the implications for health centers and their patients. 

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series presented health center case examples that explored the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encouraged participants to discuss the implications for health centers and their patients. 

Are you capturing information like immigration or refugee status, intimate partner violence, human trafficking, risk of acquiring HIV through sexual contact or substance use disorder, or other information that brings up questions about how to document or code while respecting the patient’s privacy?

This health center learning collaborative series presented health center case examples that explored the privacy and data sharing considerations of EHR documentation of sensitive patient information, such as social history and social risk, and encouraged participants to discuss the implications for health centers and their patients.