VBP CONTRACT MODELER FOR PROVIDERS

Position organizations to effectively negotiate, implement, and manage value-based payment contracts with payers through all lines of business (Medicare Advantage, MSSP, Commercial, and Medicaid).

Maximize contract negotiations, performance, and profits.

The SpectraMedix VBP Contract Modeler with financial reconciliation enables health systems, ACOs, IPAs, and IDNs to evaluate and negotiate a variety of value-based contract scenarios across different payer types. It then empowers these organizations to manage the value levers that have the biggest impact on performance and reconcile settlements.

It delivers these unique benefits though a data-driven contracting solution with integrated analytics that addresses the key cost, utilization, financial, and quality domains that impact contract terms and performance.

Achieve Your Contracting Goals

For health systems and and other large, risk-bearing provider organizations, the SpectraMedix VBP Contract Modeler provides a collaborative solution for achieving your primary objectives as you facilitate VBP contracts.

Improve Performance

Operationalize contract terms across cost, utilization, financial, and quality disciplines and target core performance improvement initiatives with the highest impact.

Optimize Your Network

Model prospective provider groups and evaluate their historical performance against your organizational benchmarks. Expand your network with the right providers.

Realize an ROI

Develop and implement contracts that position your organization and its providers for a return on investment, and manage key areas the impact your bottom line.

Benefits

Evaluate performance scoring methodologies, risk assumption options, and other contract agreements across multiple payers and lines of business.

Negotiate multiple payer contracts strategically and effectively drawing from a range of insights pulled from different contract modeling scenarios.

Manage the value levers that have the biggest impact on provider performance and return on investment across all your agreements.

Reconcile contracts quarterly to course correct as needed and perform a final reconciliation against budget to settle the contract and facilitate payments to providers.

Key Features

Flexible Market Definitions

For defining contract terms including line of business, product line, and geography.

Custom Attribution Models

Build custom attribution models that combine both plurality-based algorithms and voluntary alignment.

Quality Measures Library

Utilize a built-in library of clinical quality measures with national benchmarks (HEDIS, MIPS, eCQMs) that enable ACOs to select appropriate measures for their network.

High-Performance Networks

Create high-performance networks, including determining a common measure set, quality benchmarks, cost benchmarks, and anchoring them to VBP contracts.

Actionable VBP Analytics

Utilize standard and customized analytics to operationalize performance improvement opportunities within contract parameters.

Address Value Levers

Identify, pull, and manage the key value levers that are impacting provider performance and contractual revenue.

Model Execution and Payout

The VBP Contract Modeler is highly configurable and enables the ACO to reconcile against the budget, and facilitate payments within the provider network.

User-Defined Contract Terms

Base your contracts on the terms that matter most, including alternative budget methodologies, stop-loss limits, shared savings-loss corridors, and quality scoring.

Learn More About Our Value-Based Contracting Capabilities

Download an overview of our value-based care solutions for providers to see how you health system and provider network can achieve better contracts and performance.

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