Value-Based Care Solutions for States and Payers
A True End-to-End Partner for Value-Based Care Programs
Everything you need for a successful value-based payment program combining analytics, technology, and ongoing support with value-based care policy expertise.
Nearly a decade of proven success with effective statewide value-based payment programs
Transforming Healthcare Delivery and Payment
- Achieve better value for Medicaid funds spent on care
- Increase provider participation and risk-sharing in VBP models
- Ensure program integrity and prevent fraud, waste & abuse
- Support whole-person care and improve population health
Why State Medicaid Agencies Work with Net Health
Unified statewide programs for all providers in multiple care settings.
- Operationalize value-based care at scale
- Create consistency across MCOs and provider types
- Embed quality strategy priorities directly into payment models
- Deliver demonstrable improvements in outcomes and total cost of care
Medicaid policy and program design expertise:
- Design CMS-aligned VBP and alternative payment models
- Align payment, quality, and oversight infrastructure
- Ensure audit-ready compliance and reporting
Technology infrastructure that powers effective statewide value-based payment programs:
- Comprehensive data aggregation and management
- Unified analytics and transparent dashboards
- Real-time provider eligibility and performance solutions
- Digital member experience and survey capture
- Predictive analytics for proactive care management
Proven Success in New Mexico
- Nursing Facilities
- Hospitals
- Primary Care
Nursing Facilities
Since 2019, quality-based incentive programs have driven measurable and sustained improvement in quality outcomes and utilization.
New Mexico’s Nursing Facility long-stay hospitalization rate is significantly lower than the national average.
Hospitals
The hospital program was expanded to specialty facilities and impacts include implementation of screening for substance use disorder and referrals to treatment in EDs, improvements in behavioral health care coordination, and sustained improvements in sepsis care.
Primary Care
Launched in 2024, New Mexico’s Primary Care Payment Reform (PCPR) program is one of the nation’s few fully statewide Medicaid value-based payment models for primary care, designed to perform across diverse providers and communities.
Testimonials
“The data clearly demonstrates this investment is producing viable results in providing better quality care and improved health outcomes for our most vulnerable New Mexicans.”
Kari Armijo, Cabinet Secretary, New Mexico Human Services Department (HSD)
“Net Health’s knowledge of nursing facility data, nursing facility quality measures, and ability to collect MDSs has been instrumental to the success of the project. Their software tools are easy to use with meaningful data and analytics—both at the aggregate level and down to the facility and member level.”
Tim Voskuil, Performance and Results Consultant, Network Services, Blue Cross and Blue Shield of New Mexico!
The Highest Level of Cybersecurity
Net Health takes the utmost care to properly secure and protect customer data through policy implementation, robust technical controls and external compliance assessments.
FAQs
What is value-based care and how does it support better outcomes in Medicaid programs?
Value-based care is a delivery model that rewards high-quality, patient-centered outcomes rather than volume. Within Medicaid, value-based care strengthens whole-person care by aligning payment incentives with improvements in access, equity, and quality.
How does value-based payment improve accountability and transparency?
Value-based payment (VBP) links reimbursement to measurable performance – such as reducing avoidable hospitalizations, higher patient experience scores, or stronger care-coordination practices.
How does whole-person care fit into statewide Medicaid VBP programs?
Whole-person care requires addressing clinical, behavioral, and social needs in a coordinated, proactive way.
In what ways do statewide value-based payment models strengthen population health?
Statewide value-based care and value-based payment structures create a unified platform for identifying quality variation, monitoring trends, and scaling interventions across entire populations.
Why are states turning to partners with end-to-end VBP capabilities?
Implementing statewide VBP programs requires expertise across program design, analytics, technology, and operations. Net Health is the premier partner that designs, builds, implements, and operates statewide Medicaid VBP programs across provider types.
Better outcomes. Better value.
Net Health can help you transform healthcare delivery and payment.