Our mission is to Make ACO COntracting Affordable & Successful
We integrate cost and quality into risk contracts
Our mission is to Make ACO COntracting Affordable & Successful
We integrate cost and quality into risk contracts
About
For Employers, we offer:
- Lower trends and better member services
- Data driven advice and decisions.
- Benefit planning and care integration to grow your ACO.
- Risk & gain sharing projections.
- Interim and end of year financial reconciliation.
- Proven ACO contracts, RFPs, and tools.
- Network curation and design assistance.
For Health Systems, we offer:
- Greater market value with commercial business
- Medical & Rx data intake to create financial projections.
- Integrated cost and quality goals (i.e., it's not all about cost controls).
- Transparency of up and downside risks (i.e., no surprises).
- Use provider feedback to improve financial & clinical goals.
Our ACO Vision
- Running an ACO on data is more than trending PMPM and utilization.
- Building and curating an ACO should not be about narrow networks.
- Contracting with providers is more than selecting the few low-cost high quality (if even possible).
- Quality is more than adding HEDIS to quality metrics.
- Integrating cost and clinical data is about prioritizing resources into a short and long-term success.
What we offer – ACO in a Box
- We offer DIY options to make ACO contracting affordable.
- We integrate vendors and provider solutions.
- We help make ACOs more attractive to your members.
- We use data and benchmarks to improve clinical and cost efficiencies.
- We help you build a full-service network.
Buying Value not Volume
Value - Lowers cost & Improves care
Finding providers and systems to deliver value requires understanding where they are, what they can provide, and whether they can sustain value over time. The scenario example above shows one system hitting contract trend, quality, access, and service targets year over year. The two other scenarios falter. However, their contract risk only affects their revenue, a small number compared to the payer's commercial reimbursement. We model each contract component, making risk more transparent to ensure the first example is more likely than the other two.
Pricing Below
Value-Based Payment Strategies offers value contracting services tailored to your unique needs. We work closely with your team to design a plan that encompasses benefits changes, savings estimates, and strategies to 'lower cost and improve care.'