Tag Archives: risk-based contracting

Do bundled payments encourage more procedures? New study offers answer

New research aims to determine whether a claim that bundled payments may actually increase costs rather than control them holds any weight. Becker’s Hospital Review and McKnight’s reported on the study from the Centers for Medicare and Medicaid Services and the Altarum Institute. At issue was whether bundled payments — also known as episode-based payments […]
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Addressing the possible effects of overlapping reimbursement models

At the core of bundled payments is the goal of improving coordination between all of the facilities and agencies a patient might visit or employ during one episode of care. But as health care providers adjust to this new reimbursement model, some are experiencing trouble coordinating bundled payments with other value-based care initiatives. In the […]
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Blazing the path of progress in value-based care

There is no one path to provider risk. Market dynamics, culture and history are among the elements that make each organization’s path unique. Providers that are transforming on the volume-to-value continuum all find themselves at various points in the process. Paths to risk can be cautious. For example, hundreds of organizations, whether they are hospital-centric […]
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Sowing the seeds of change in value-based care

Any business leader will tell you that keeping up with market shifts is crucial for financial success. That is especially true in health care today. As the market moves from fee-for-service to fee-for-value reimbursement, organizations face huge challenges in transforming their operations, finances, physician relationships, culture and patient engagement — all while the industry moves […]
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The risks and rewards of value-based contracting

In the new Optum white paper, “The speed of transformation: Preparing for the payment models of tomorrow,” we discuss the drivers that are pushing the move to value-based reimbursement. One area that will see some of the greatest — and fastest — changes is contracting with payers. Moving to fee-for-value creates significant financial risk for […]
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Keeping up with the fast-moving changes of value-based health care

Any business leader will tell you that keeping up with market shifts is crucial for financial success. That is especially true in health care today. As the market moves from fee-for-service to fee-for-value reimbursement, organizations face huge challenges in transforming their operations, finances, physician relationships, culture and patient engagement — all while the industry moves […]
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How to strategize when the strategic goal is unknown

One of the contradictions of value-based care is that we know we need to plan, yet we’re not always sure what we’re planning for. The old adage that “when you fail to plan, you plan to fail” applies here, but planning without seeing the entire picture means you may be taking your organization into dangerous […]
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Health care providers respond to market push toward value-based care

Announcements from several commercial payers along with the Centers for Medicare and Medicaid Services (CMS) early in 2015 around increased efforts to form value-based contracts with providers seemed to point to an impending rise in risk-based contracting. In addition to this increasing market pressure, the reality of hospitals and health systems nationally continuing to see […]
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Engaging in risk-based contracts? Get an actuary’s opinion

Health care providers across the country are looking at ways they can increase their clinical and financial risk exposure under value-based contracts. But if they’re not experienced with risk, they may enter into contracts that put them in difficult situations. The consequences of bad risk contracts could include poor cash flows, non-competitive rates resulting in […]
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Provider executives share insights on the evolution of population health

How can you adapt to population health? If you’re a health care provider, such a question can’t be answered in a sentence or a paragraph—or even an entire article. But providers who are undergoing a fee-for-service to fee-for-value transformation have offered some insight into how and why they’re evolving to become excellent at managing the […]
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