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The Valued Plan Partner

Health plans use alternative payment models to align provider incentives with Triple Aim principles: lower cost, higher quality, and better experience for patients. Despite a decade of shared vision, providers have yet to substantially take on downside risk.

To change providers’ profit outlook and promote participation in downside risk, health plans must look beyond financial incentives to support creative operational improvements that meaningfully enhance clinician experience. In this deck, we showcase the payment models, data, analytics tools, and utilization management adjustments that enhance provider willingness and capability to accelerate their engagement in downside risk.

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