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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

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