Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.

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Value-based care should be more than a buzzword by now

Advancing commercial risk will be a critical catalyst of progress

Risk-based payment models are progressing slowly but steadily for Medicare and Medicaid. The same can’t be said for commercial contracts, where it’s harder to find alignment between plans, providers, and employers on compressed timelines. But commercial risk is ultimately what will tip the industry toward value-based care or keep us stuck in a world of hybrid incentives.

Advisory Board has been researching whether commercial risk is possible. (Spoiler alert: We believe it is.) To understand the path forward, we’ve collaborated with experts from around the industry and analyzed a national database of commercial claims. Explore our work below to learn how you can help push the industry toward a new cost and quality standard.


Our take on commercial risk: it's complicated but achievable

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Commercial risk is possible—here’s how
The health care industry has yet to land on a clear model for advancing commercial value-based care. The barriers are real and progress has been slow, but the industry can get there.
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Why commercial risk is still a wildcard

It’s not surprising that progress against commercial value-based care has been unpredictable because extracting savings is hard. Here’s where to focus to make progress.


What our analysis of commercial claims data is telling us

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Data Analysis
Where the commercial risk opportunities are

Our analysis of a national database of commercial claims illuminated where opportunities to improve cost and quality outcomes for the privately insured exist – and where we might see increased costs.

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Data Analysis
Pregnancy care opportunities

Maternal health outcomes in the U.S. lag those of other industrialized nations despite significant spend. Find out where you should focus, and where you should not. (For Advisory Board members only.)


The fears and barriers standing in the way

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Blog Post
The four fears holding the industry back

In a recent workshop with 44 executives from provider, health tech, life science, and finance organizations, we surfaced top fears about taking on commercial risk.

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The barriers to commercial risk

It’s hard to find consensus on the future of commercial risk. Learn about the many reasons for pessimism, but also why some view it as a necessary pursuit.

For members: Featured resources to support implementation of VBC

Win physician buy-in for value-based care

Four principles to successfully engage your frontline clinicians in VBC

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How health plans can support providers in risk

Three ways that plans can get providers more comfortable with risk

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Population health cheat sheet library

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How to scale chronic disease management programs

Three steps for developing a scalable and effective program

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How to improve your risk performance

Insights on what makes ACOs successful, based on analysis of MSSP data

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Refining your approach to risk stratification

Three ways to find the high and rising risk patients who are also actionable

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