Health Care Financing

Leveraging the possibilities of value-based care

As the clinical and financial advantages of value-based care become clearer, administrators of care delivery systems are challenged to redesign how care is delivered in order to maximize financial benefits. This may require modifying existing care delivery models or designing entirely new integrated care solutions.

To connect these components, we assess and address financial and operational issues associated with emerging payment models, changes in reimbursement structures, quality measurement, new reporting requirements, and incentives to maximize provider participation. We have helped the Centers for Medicare & Medicaid Services (CMS)—the largest payer in the country—and others in developing and evaluating value-based care models. By partnering with us, you can find sustainable and unique solutions so that you benefit from value-based payment models.

Further, with a deep understanding of health policy and the way value-based care initiatives affect payers, providers, and patients, we are well equipped to inform payer strategies. We can design innovative value-based payment systems for various populations and care settings, support provider collaborations, and advise employer programs while prioritizing patient engagement.

Areas of Expertise

  • Financial Metric Development and Benchmarking
  • Program Design, Implementation, and Evaluation
  • Patient Attribution
  • Risk Stratification and Adjustment
  • Provider Education and Engagement

 

Selecting a Downside-Risk Payment Model

Imagine a health care system where patients get the best possible care—and at an affordable price. That is the mission behind value-based health care. Under traditional fee-for-service arrangements, providers receive…
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White Paper: Campaigning on Care: What 2020 Candidates’ Proposals Mean for Value Based Payment

Sweeping change to the structure and funding of the U.S. health care system has emerged as a dominant issue in the 2020 U.S. Presidential Democratic primary. Most of the candidates’…
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The Medicare Shared Savings Program

Medicare provides insurance to approximately 55 million Americans. Most beneficiaries are 65 or older, and many receive their health care from multiple doctors, hospitals, and other providers. For more than…
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Bundled Payments for Acute Care Hospitalization Episodes

This project demonstrates the effectiveness of a bundled payment to align incentives for both hospitals and physicians and also tests the effect that transparent price and quality information may have…
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Performance-Based Incentive Payment (PBIP)

The performance-based incentive payment (PBIP), a new payment model being piloted through Comprehensive Primary Care Plus (CPC+), is intended to focus practices’ attention on patient experience, clinical quality, and utilization…
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Download our Health Care Financing overview to learn more about how we can help you leverage the possibilities of value-based care.
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