Value-Based Care Consulting
Custom support for population health executives to move confidently from volume to value with:
- Detailed assessments of capabilities and opportunities
- Tailored roadmaps that lay out the right investments to make, and when
- Elbow-to-elbow or interim support for optimal impact
Over the next decade, some providers are expecting to channel more than 80% of patient revenues through risk-based contracts—mostly through shared savings.
That prediction is playing out as health systems across the country form Accountable Care Organizations (ACOs)—both through Medicare and the private sector—to better coordinate patient care, and tightly manage cost and quality.
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Establishing a strong foundation for ACO development
Participating in this model is an attractive choice for many provider organizations—but with the financial risks involved, it’s critical to ensure that the infrastructure is primed.
There are a number of foundational steps organizations should take to determine whether or not this is a viable strategy for them in the transition to value-based care, and to ultimately ensure that savings and bonuses are achieved. These include evaluating and engaging physician partners, improving referral pathways, deploying IT and analytic systems, and developing care management models.
As mixed results come out regarding initial Medicare Shared Savings Program (MSSP) performance, it’s clear that the road to becoming an effective ACO is a complex undertaking. Ensuring readiness long before launching a program is a critical step to avoid losing key physicians and market share—which can happen quickly and aggressively once the program is deployed.
How we help
Whether looking for assistance in submitting an MSSP application to CMS, or guidance in developing a Next Generation ACO, we provide end-to-end support across the entire process. Recognizing that each organization’s circumstances are different, we start by establishing a baseline through a customized assessment that examines market dynamics, current operations, financial opportunities, the IT and analytic foundation, and the physician community.
Readiness Assessment and Strategic Development
- Conduct baseline assessment to determine appropriate alignment platforms and quality improvement programs
- Educate and enfranchise key stakeholders, including physicians
- Estimate financial opportunities under proposed programs and payment models
- Develop a strategic roadmap for achieving desired objectives and physician alignment
ACO Application Preparation and Submission
- Provide all necessary documentation and data to CMS
- Facilitate completion of ACO application
- Manage communication to key stakeholders
ACO Program Formation
- Prioritize high-risk patient populations for care management teams
- Identify potential organizational partnerships across the full continuum of care
- Ensure high standards are met for care quality across multiple dimensions
- Demonstrate care coordination across all sites of care over time
- Design program structure and identify infrastructure needs for successful operations—including staffing, management, and IT
Hunter Sinclair, MBA
Hunter specializes in Medicare risk strategy, ACO and other accountable payment models, the development and operationalization of MSSP initiatives and clinically integrated networks, and providing strategic guidance to organizations navigating the transition from volume to value. More.
Hear how we can help your organization
Request a session with one of our experts to hear about forming an ACO program.
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Putting the 'share' in shared savings