Transforming How Payment Reform is Deployed
Making ACOs simultaneously work for the Medicare program, commercial health plans, providers, and patients is a complex endeavor. RTI Health Advance’s diverse team of experts help clients address financial and operational issues associated with payment reform, including emerging payment models, changes in reimbursement structures, quality measurements, reporting requirements, and incentive structures to design, implement, and optimize your approach no matter where you are on your value-based care journey.
Our Expertise
- Next Generation ACO Strategies and Validation
- Alternative Payment Model Design and Adoption
- Outcomes-Based Contracting Strategies and Development
- Price Transparency Strategies and Adoption
- Bundled Payment Modeling and Validation
- Risk Adjusted Design, Implementation, and Evaluation
We've Been Implementing Payment Reform from the Beginning
Operationalized the ACO model
We designed the implementation of the accountable care organization (ACO) model from its inception to developing the Medicare Shared Savings Program (MSSP) critical operational elements to make ACOs successful.
Developed Algorithms for Risk-Adjustment Payment Model Methodologies
We created and maintained risk-adjustment methodologies to support Medicare Advantage and Part D capitated risk to enroll and service a broader population.
Advanced the P4P Model
We created and implemented the performance-based incentive payment (PBIP) for the Comprehensive Primary Care Plus (CPC+) model to strengthen primary care through regionally based, multi-payer payment reform and care delivery transformation.
Operationalized the ACO model
We designed the implementation of the accountable care organization (ACO) model from its inception to developing the Medicare Shared Savings Program (MSSP) critical operational elements to make ACOs successful.
Developed Algorithms for Risk-Adjustment Payment Model Methodologies
We created and maintained risk-adjustment methodologies to support Medicare Advantage and Part D capitated risk to enroll and service a broader population.
Advanced the P4P Model
We created and implemented the performance-based incentive payment (PBIP) for the Comprehensive Primary Care Plus (CPC+) model to strengthen primary care through regionally based, multi-payer payment reform and care delivery transformation.
Our Experts
Tara Quagliaroli
Luke Horvath
Laurie Gavitt-Smith
Heather Rast
