Tag Archives: value-based contracting

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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Focus on the future when developing your provider network

Every health system and provider organization entering into risk-based contracts needs to focus on the types of providers they want in their network. The type of providers they want will depend on the services they provide and the geographic coverage they need. However, a network should not be static as providers take on additional levels […]
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Vantage Cancer Care Network makes risk work in specialty care

The pay for value revolution is here, and it means significant changes to the way primary care is provided to patients. But what does it mean for specialists? In risk-based contracts, primary care providers such as family physicians, pediatricians, OB/GYNs and internists are relied on to keep patients healthy and well. Meanwhile, the industry is […]
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After promising results, Medicare will likely continue expanding risk-based contracting efforts

In our last blog post, we shared a few reasons why risk-based contracting in health care is here to stay. In this post, we’ll share some data points that point to current and future impacts on the industry, and a few suggestions to help you jump on the value-based train. The value-based train has left […]
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Health plans expanding risk-based contracting efforts

Are risk-based contracting arrangements between health insurers and providers here to stay? The answer can be summed up in three words: “Follow the money.” Health plans are investing in and paying for an increasing amount of care covered by risk-based contracts. And these contracts aren’t just with the obvious accountable care organizations (ACO) and patient-centered […]
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Innovative payment approach for successful value-based reimbursement models

As you see health care transitioning away from traditional fee-for-service payments and toward performance-based payments, value-based reimbursement (VBR) approaches are becoming popular options for health plans. Pay-for-performance contracts, patient-centered medical homes, bundled payments and accountable care organizations offer unique value creation while allowing payer organizations to work collaboratively with their provider partners. Payers are looking […]
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Thoughts On Provider-Based Predictive Modeling In Value-Based Contracts

Analytics to predict future medical costs of individuals and populations are limited by the characteristics of the three types of available data. 

Four Steps to Success in Value-Based Contracting

In my many meetings with physician groups who have enjoyed success in value-based contracting (VBC), the same four areas of critical focus are repeatedly articulated by executive leaders of these organizations.