Value-Based Care Consulting

A fully customizable service for payers and providers that want to collaborate with providers to coordinate care, implement value-based reimbursement models, and drive improved outcomes at a lower cost.

Transition to Value-Based Care 

Leverage our deep expertise to help you select care models and engagement strategies, conduct cost/quality analyses, reward performance, and track results.

Analyze local market dynamics and potential provider engagement to determine which value-based care models to pursue.

Build collaborative Payer/Provider relationships to implement best practices, develop provider performance incentives, and reduce the cost of care.

Identify, evaluate, and recruit primary care providers and high-performing specialists for value-based care program participation using intelligent analytics.

Direct referral volume to a high-performance network of specialists by facilitating primary care physician referrals to more cost-effective, high-quality care.

Establish administrative support processes for measuring program results and managing payment distribution and reconciliation.

Impact Population Health With Value-Based Strategiest

Assess Quality and Outcomes

  • Determine optimal care models by analyzing your local market, assessing factors such as demographics, SDOH-related needs, insurance coverage, and the number of independent vs. employed physicians.
  • Rely on our expertise in care model design and implementation to launch a value-based reimbursement model such as bundled payments, pay for performance (P4P), or patient-centered medical homes (PCMH).
  • Align payments with cost, quality, and outcomes by analyzing your claims data; establishing financial, quality, and efficiency benchmarks; and integrating existing models of care with new models. 

Engage Members and Physicians

  • Leverage our consulting expertise for both payer contracting and third party payer contracting to help your business grow. 
  • Nurture provider trust by sharing timely, transparent quality and performance metrics; identify opportunities for performance improvement and improved patient care decisions. 
  • Facilitate provider participation in new care models with customized engagement strategies incorporating data analytics, educational outreach, experience surveys, and utilization and quality metric performance. 
  • Create communication campaigns to encourage members to choose high-quality, low-cost providers and services. Use predictive analytics to identify rising risk members and help close gaps in care.  

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