Ultimately, the financial side and the clinical side of the ACO equation need to be in balance. Adjusting to the financial realities of value-based contracting is essential. Therefore, our fourth risk-bearing action for provider organizations is financial and capacity planning.
Provider organizations that want to bear patient risk need to be informed by their local markets and the attending health care concerns that come with that market. That’s why our third action that leads to bearing risk is population-based planning.
Taking on patient risk requires careful planning and the right leadership to carry it out. That’s why developing the correct structure is the second of five actions that allow your organization to take on medical risk.
In a previous post, we outlined the five key actions needed to begin and successfully take on patient medical risk in a value-based reimbursement environment: Market Assessment; Strategic Structure; Population-Based Planning; Financial and Capacity Planning; and Value-Transformation Road map.