Identifying Challenges to Value-Based Payment and Contracting Structures

Value-Based Payment and Contracting Structures collaborative will address both the structures needed to expand efforts in value-based contracting/payments and changes to current business processes. The State’s vision is to infuse the public system with value-based contracts and payments and follow the national trend. In support of this vision, Dave Richard, Deputy Secretary for Medical Assistance participated in the first collaborative meeting and offered the state’s views on VBP in our system.

In recruiting members for this business-focused collaborative, i2i Center identified providers, payers, and state representatives. As the initial round of technical issues and barriers are identified and addressed, it is expected that the work of this initial group will be refocused, likely with wider representation, to address the future of VBPs and additional issues related to service and quality strategies.


In 2018, the i2i Center, through a provider assessment, recognized that there are currently challenges in expanding the use of value-based purchasing (VBP) models.  A Collaborative made up of three LME/MCOs, three statewide providers, and two NC DHHS representatives has been meeting to identify the challenges in value-based purchasing.  The Collaborative is developing a pilot proposal to implement VBP within one current service.  Outcome metrics have also been drafted.

In 2019, the Collaborative will develop a plan of action for this pilot. Part of the next steps will be gaining additional support from key stakeholders.  NC DHHS Deputy Secretary for Medicaid Dave Richard has shown support for the work of this Collaborative as it will help inform the work being done within NC DHHS on the BH/IDD Tailored Plans.

Lead Staff

Mary Hooper, MSW, ACSW, Executive Director

Ann Rodriguez, MHA, Assistant Director


i2i Center for Integrative Health