Value-Based Care Agreement

Organizations should also consider whether they are able to withstand the redeployment of resources and potential additional costs to create a broad value-based program that could result in downstream savings in improving patient outcomes. [2] This is the assessment of the existing infrastructure and its response to the specific requirements of a value-based contract. Infrastructure issues focus on the ability to identify and define a way to track product and patient utilizations and provide financial assistance to suppliers/patients who use the Life Sciences product (if any). [3] Rising savings programs may be the best place to start perfecting care management techniques for the early years. If providers feel confident that they have sufficient infrastructure to effectively manage the care of assigned patients – and that the cost of care is correct and payments exceed these costs – they will be prepared to take deeper risk initiatives such as pooled payment, head management and ownership of the health plan. Incomplete data is often a problem. Insurers cannot provide suppliers with all price information due to data protection agreements with other supplier networks. “Sometimes it`s absolutely frustrating,” said Dr. Christopher Crow, president of Catalyst Health Network, based in Texas, which brings together about 600 primary care providers.

– Product selection analysis: What are the most appropriate products for value-based contracting? For example, high-rate consumers choose ambulatory imaging services based on price. The price is also the basis for the choice of individual health insurance for consumers in health insurance funds created by the Affordable Care Act. And employers include price considerations in choosing network operators for expensive surgical procedures. In response, health systems are lowering prices at the single-unit service unit level and focusing on reducing costs by improving care management – and reducing the cost of care, reducing premiums. As more payers, providers and life sciences organizations embark on VBC travel, it is essential for organizations to understand the individual levers of success for each entity in order to put their organization in the best possible position. Companies can increase their chances of achieving VBC success by addressing the following fundamental issues when they first consider entering into a VBC agreement: UnitedHealthcare cannot reveal specific prices to their customers, but it tries to circumvent that by breaking down the cost of services in stages, Nguyen said. 6. Assess current patient care, benefits and hospital interventions. She advised hospitals to ask: “Is this the best care today? In the best environment? Is care coordination well managed? She said organizations should identify gaps and then fill those gaps with selected investments, ambulatory care networks and new and existing partnerships.