Payment Model Reform

Payment Model Reform


Effective strategies for value-based reimbursement.


As government and private payers transition reimbursement to value-based models, you’ll need to transform care delivery and be willing to put revenue at risk to achieve quality and cost-savings metrics. Knowing the financial impact in moving from volume to value and having the strategies to improve your value metrics are critical.

Our approach includes data analysis, a readiness assessment and gap analysis, education, and specific insights and recommendations for changes to meet the challenges of value-based reimbursement. In the end, we’ll partner to develop and execute strategies to create high-quality, cost-effective care in ways that work best for your organization.

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“A transition to a successful payment model requires a different approach to care delivery with more transparency and focus on greater patient engagement and reducing the costs of care. We help our clients prepare for the ever-increasing complexity and financial impact of changes in care and payment models.”

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

Payment Reform Overview for Healthcare Leaders
Through tailored, interactive overview sessions, a common knowledge baseline about value-based reimbursement is established. Sessions address innovative payment models, their impact and initial readiness strategies. This sets the stage for clear alignment among clinical, executive and administrative leaders and awareness around the financial impacts to clinician and health systems.

Financial Impact Analysis
Whichever value-based initiatives you deploy, you need a clear understanding of the different short- and long-term implications on clinicians’ reimbursement and, ultimately, your bottom line. An in-depth analysis of data and market rates can quantify the financial impact of the new value-based payment models, allowing you to determine the best opportunities to pursue for long-term success.

Readiness Assessment
Will you be ready when Medicare and commercial payers tie the majority of your revenue to outcomes and cost containment? 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 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 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 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.