Phase 1 Grantees Built Capacity to Advance Value-Based Payment and Care, Despite Challenges of COVID-19

The Delta Center for a Thriving Safety Net’s goal has been to advance value-based payment and care (VBP/C) in the ambulatory care safety net by bringing together state primary care associations (PCAs) and behavioral health state associations (BHSAs) to collectively advance improvements in VBP/C.



In its first three years (Phase 1), the Delta Center awarded grants to 12 state PCA and BHSA teams to build their relationships, identify common goals and promising strategies, and conduct projects to advance policy and care change in their states.

“I think that we worked together more closely than we ever would have without the Delta Center. It wasn’t like an antagonistic relationship before; it was a relationship that had become a bit moribund. Because of this grant, we've had the pleasure of getting to work together.”

— Delta Center Grantee

Evaluation findings from Phase 1 revealed that grantees made progress in building their capacity and relationships to advance VBP/C. The findings are based on data collected and analyzed by JSI and Mathematica. Key accomplishments include:

• Building the internal capacity of state associations. State associations institutionalized their VBP/C efforts by creating formal structures and processes, and increased the degree to which they formalized and used their organizational strategy to achieve their objectives.
• Building policy and advocacy capacity to advance value-based payment and care at a state level. The proportion of PCAs that reported having shaped significant policy changes with their state Medicaid agency increased from 9 to 46%, and it increased from 0 to 63% among BHSAs.
• Fostering collaboration between primary care and behavioral health at the state level. Many state associations cited that the time to focus on their shared work via the Delta Center was crucial to their relationship development. Many Delta Center participants shared a similar sentiment as that expressed by one of the teams: “We’ve developed a culture of true partnership.”
• Building capacity of state associations to provide education and technical assistance to advance value-based payment and care among members. The percentage of associations that engaged in semi-regular or regular shared opportunities to provide training and technical assistance to members from both organizations nearly doubled from 42% to 81%.

The evaluation report describes these accomplishments in more detail, along with the implication of COVID-19 on grantees’ activities, participant perspectives on the Delta Center, and recommendations for Phase 2 of the Delta Center. In Phase 2, eight of the Phase 1 states have received alumni grants to help them continue their work and incorporate a greater focus on racial equity and consumer voice.