Value-Based Care

Changing How We Do Healthcare

Trillium and its provider network are moving beyond the traditional fee-for-service model to implement innovative value-based care (VBC) arrangements. Unlike fee-for-service, which reimburses based on volume of services, value-based care emphasizes outcome, tying payments to the achievement of realistic, measurable health goals.

This approach supports the Quadruple Aim of healthcare, a guiding principle of Medicaid Transformation in North Carolina:

  • High-quality care
  • Cost-effective care and treatment
  • Better health for our communities
  • Improved member and provider satisfaction

Value-based care is central to Trillium’s strategic direction, ensuring that care delivery is not only efficient but also person-centered and impactful.

Trillium is committed to aligning with the North Carolina Department of Health and Human Services’ (NCDHHS) vision: to improve the health of North Carolinians through an innovative, whole-person-centered, and well-coordinated system of care. This includes a strong focus on both medical and non-medical drivers of health, such as housing, food security, and transportation.

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The Department’s strategy – Better Care, Healthier People and Communities, and Smarter Spending – is reflected in Trillium’s ongoing efforts to build a sustainable, outcomes-driven healthcare system that meets the needs of both members and providers.

Quadruple Aim

Quadruple Aim graphic in colors orange, yellow red and green

Practice Management

The Practice Management team collaborates closely with multidisciplinary, cross-functional teams to design and implement value-based payment initiatives that drive improved outcomes, quality, and efficiency across the provider network.  

Our multidisciplinary team brings together clinical and operational expertise to design and implement innovative approaches that support value-based purchasing models.  

These models are built to:

  • Drive measurable improvements in member health outcomes

  • Incorporate evidence-based quality metrics

  • Offer flexible design tailored to diverse provider specialties

  • Enhance the member healthcare experience

  • Reduce per-person healthcare costs

  • Integrate care coordination across specialties to support whole-person care and improve access

Practice Management Consultants work directly with providers to lead performance improvement efforts, track outcomes, and strengthen service delivery. The team also supports provider network development, recruitment, retention, training, and education.

We collaborate with providers to identify key focus areas and capabilities needed to participate in alternative payment models (APMs) across all populations served by Trillium.

As part of our approach, Trillium assesses each provider’s readiness for value-based arrangements, which may include components such as data reporting, performance-based payments, and shared financial risk. We align our payment methodologies with the Health Care Payment Learning & Action Network’s Alternative Payment Model Framework (HCP-LAN) to ensure consistency and transparency in our value-based strategies.  

Health Care Payment and Learning Action Network Alternative Payment Model Framework 

The Health Care Payment Learning & Action Network (HCP-LAN) Alternative Payment Model Framework serves as the industry standard for guiding how payers and providers design alternative payment methodologies and establish value-based payment goals.

The framework categorizes value-based payment models into the following categories: 

Four categories that value-based payment are classified. They are Category One Fee for Service - No Link to Quality and Value; Category Two Fee For Service - Link to Quality & Value; Category Three APMs Built on Fee-For-Service Architecture; and Category Four Population-Based Payment.

Trillium’s Value-Based Purchasing Provider Learning Series

Value-Based Purchasing Provider Training: located on our Provider.MyLearningCampus.org site

  • Value Based Purchasing Series Part 1: The drivers shaping the movement to a value-based contracting business model. Key competitors and potential partners.
  • Value Based Purchasing Series Part 2: Are you ready for value-based reimbursement? An Executive Guide for assessing readiness in a value-based market.
  • Value Based Purchasing Series Part 3: Creating a focus on what matters to customers. Aligning culture and technology to drive performance. Driving success with key performance indicators.
  • Value Based Purchasing Series Part 4: Implementing a market approach to new service development.  Development of a new service & business cost model and the return on investment ROI) of a new service model

Additional Resources

Health Care Payment and Learning Action Network

North Carolina was one of four states selected to participate in a new multi-stakeholder Alternative Payment Model (APM) initiative that will build directly on North Carolina’s Medicaid managed care transformation work.

Open Minds
Duke Margolis Center for Health Policy
NC Department of Health and Human Services Quality Management and Improvement
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