Payment Model Reform

Payment Model Reform


Effective Strategies for Value-Based Reimbursement


To create a successful value-based care payment model, you’ll need to evaluate the way you deliver care overall. What are the financial implications of going from volume to value? What strategies should you be focused on to successfully transition — whether you’re considering Shared Saving Plans, Bundled Payments, Advanced Alternative Payments Models, Merit-based Incentive Payment Systems or as part of an Accountable Care Organization?

Through education, readiness assessments and gap analysis insights, we’ll help you assess your best options. We’ll look for gaps in your Medicare Access and CHIP Reauthorization Act (MACRA) compliance, reporting and data submissions and help ensure you’re receiving the appropriate reimbursement amounts. The end result: a partnership that delivers strategies designed to drive high-quality, cost-effective care in ways that work best for your organization.

Meet Our Healthcare Team

“Although an organization may be ready for MACRA now, they may not be ready in two years as transition continues. We help our clients prepare for the ever-increasing complexity and financial impact of legislative changes.”

We offer a full range of solutions to help you be successful in value-based reimbursement.

Payment Reform Overview for Healthcare Leaders
Through a tailored, interactive overview session, a common knowledge baseline about value-based reimbursement is established. Education around MACRA legislation and its impact, along with initial readiness strategies, is discussed. This sets the stage for clear alignment among your clinical, executive and administrative leaders with awareness around the potential impacts to clinician and health system income.

Financial Impact Analysis
Whichever value-based initiative you choose to go with, you need a clear understanding of the different short- and long-term implications on your clinicians’ reimbursement and, ultimately, your bottom line. An in-depth analysis quantifies the financial impact of the new value-based payment models, to determine the best opportunities for your organization to pursue for long-term success.

Readiness Assessment
Will you be ready when Medicare ties the majority of payments to outcomes? When commercial payers follow? A customized Readiness Assessment will identify your information and process gaps, as well as specific insights and concrete actions that enable you to implement appropriate value-based reimbursement strategies.

Strategy Planning
The best value-based reimbursement strategies for your organization depend on your current state of readiness, tolerance for risk and available resources. Using different scenarios, Strategy Planning charts your organization’s path forward with data-driven insights reflecting your current and potential performance.

Integration and Due Diligence Consulting
With deep integration experience, we’ll help you explore merger and acquisition opportunities and various other types of affiliation and interoperability strategies to optimize both your financial performance and competitive position.

Provider Compensation Model Design
The right compensation model will help you be able to find and keep the leaders you need to deliver consumer-centric care. We’ll conduct interviews, gather the latest industry insights and collaborate to produce a design model that rewards behaviors aligned with your value-based reimbursement goals.