Medicare Risk Strategy: Opportunities for Risk Contracting in Medicare Advantage
The second presentation in the Health Care Advisory Board’s two-part series on “Medicare Risk Strategy” moves beyond the Medicare ACO programs to examine opportunities for risk contracting in Medicare Advantage (MA).
With enrollment growing rapidly and MA plans continuing to enjoy relatively high levels of reimbursement, providers who secure strong and performance-driven risk contracts stand to share in the financial benefits of MA. MA offers some unique benefits that the ACO programs don't, including the ability to experiment with narrower networks and modify benefit design to encourage use of high-value services. This on-demand presentation examines the hallmarks of a successful risk-based contracting strategy in Medicare Advantage and provides a framework for negotiating with private MA plans. Moreover, this on-demand presentation examines not only how to establish strong contracts upfront, but how to sustain your risk contracting strategy across the long term.
Things You’ll Learn:
- Why Medicare Advantage risk should be a component of any Medicare risk strategy
- What partnership models are available for provider-sponsored MA—and when to pursue them
- How to ensure the longevity of risk contracts in both Medicare Advantage and Medicare ACOs