Expertise
As the healthcare industry shifts toward value-based contracting, the responsibility for financial risk and reward is moving from health plans to provider groups.
Extensive experience in population health, financial analysis, and program design on the health plan side allows VBC Partner to guide you through the complexities of value-based contracting, managing financial risk and VBC performance.
Population Analytics
Healthcare is about taking care of people, which is why it is essential to identify the patients who need focused attention and care management.
VBC Partner offers you expertise in designing population assessments, recommending data sources for the identification of social determinants of health (SDoH), risk stratification, and predictive modeling that can help you identify these patients and ensure they receive the care they need.
Upside & Downside Risk Structure
Innovators have opportunities to manage the total cost of care through value-based contracts.
VBC Partner can review contracts, discuss value-based design options and set performance targets.
Risk Adjustment
Government payers pay more for patients and members with evidence of increased morbidity based on diagnosis code reporting.
VBC Partner can explain concepts and models, outline differences between Medicare Advantage, Medicaid, and ACA/commercial, design programs, evaluate vendor partners, assist you with incorporating risk adjustment into contract terms and help you monitor performance.
Medicare Advantage
If you are contracting with Medicare Advantage organizations or contemplating starting an MA plan, the concepts above are critical to setting your organization up for success.
VBC Partner can outline process steps, guide you through key considerations and assumptions, and identify third parties you may need to support you.
Why VBC Partner?
VBC Partner offers comprehensive services like reviewing contract proposals to identify risks and rewards, recommending favorable performance criteria, providing guidance on risk adjustment, population health assessments, risk stratification, social determinants of health, and cost and utilization management.