VALUE BASED INITIATIVES
Government and commercial payors continue to assert their intention to increase the number of value-based payment arrangements, a methodology heavily influenced by provider performance and patient outcomes. We offer services to help initiate and evaluate value-based arrangements.
Pay for Performance – Value Based Reimbursement
Value-based payment models continue to enhance or replace existing payment methodologies to establish a larger emphasis on the quality component of payment. While each value-based arrangement contains unique components, the objective remains consistent, secure enhanced reimbursement for efficient and effective care resulting in better health outcomes. Our process considers the critical components necessary to implement a successful value-based agreement.
Evaluate the current Managed Care Contract Position of the healthcare provider
Identify the Population Health Improvement Opportunity for conditions and characteristics
Determine the Value Based Models appropriate for the healthcare provider contract position and population served
Collaborate with the managed care plan to Define Capabilities & Tolerance
Select the Quality and Performance Measures devoted to the reduction of cost and management of risk
Construct the Framework that aligns with the managed care plan and healthcare provider protocol
Execute the Agreement with enhanced reimbursement for exceptional performance and improved outcomes
Review healthcare provider performance and Recalibrate the value based model