Delivering Quality and Excellence. Every Service. Every Client. Every Day.

Quality and Value-Based Care

Vendor Management
  • Value Based Care Value-based payment can be a winning proposition, so long as an organization has all the right pieces in place.
  • In the new era of value-based payment contracts, health systems will require a business and clinical model designed to help them assume increased risk. If value-based payment contracts with a health system’s sponsored accountable care organization (ACO) or clinically integrated network (CIN) are to be more than simply the next incarnation of pay-for-performance, they must lay the groundwork for a comprehensive population health management strategy, with all the pieces in place to effectively manage the cost of care.
  • Balance the use of traditional and new metrics
  • The challenge for most health systems pursuing the value-based payment model is that they must do so while continuing to operate in a fee-for-service (FFS) world. That means they must continue using traditional FFS metrics focused mainly on volume while also developing new metrics and skill sets, such as:
    • Analyzing measures such as episodes of care for chronic conditions, utilization rates and practice pattern variations, deviations from care pathways and errors in outcomes reporting
    • Becoming proficient in benefit design, product pricing and curation of care networks
    • Understanding how the benefit design and payment rate changes described in the contracts will affect utilization rates and financial performance.

Learn more about our comprehensive administrative services.