Embracing Value-Based Contracts - Five Keys to Success for Health Plans
Value-based contracting is a complicated process. Payers need tools that enable their contracting teams to standardize every step—from modeling to...
Modeling a value-based contract is often a time-consuming process. There are so many variables to contend with—incorporating relevant quality and utilization metrics; attribution related to primary care, specialist, or behavioral health providers; selecting types of contracts ranging from quality-based incentives to shared savings, shared risk, capitation, episodes, and more; other additional financial parameters; timeliness of incentives payment—the list goes on and on. Different states with unique goals to improve healthcare also add additional complexity to these arrangements.
With the pressure on payers to develop win-win agreements while still maximizing their own ROI, it’s important to have standardized processes in place so that replicating successful contracts isn’t a heavy lift.
Based on our experience providing advanced contracting and performance improvement solutions to health plans, here are the key benefits to your health plan by establishing a standardized contracting process:
Conclusion
A key step in developing a standardized value-based contracting process is to identify an advanced solution designed to bring the benefits outlined above to fruition. It should provide key capabilities including modeling automation across business lines, performance improvement analytics, user defined contract terms, and advanced provider enablement solutions. If you’re interested in learning more about how our contracting standardization solutions can help you to achieve success in value-based care, please take an in-depth look at our value-based care solutions.
Raj Lakhanpal
Value-based contracting is a complicated process. Payers need tools that enable their contracting teams to standardize every step—from modeling to...
During the value-based contracting process, health plan executives should be prepared to do all of the following: evaluate risk options and terms,...