As reimbursement changes, payers and providers have to collaborate like never before.
Where are your biggest opportunities to move the needle?
What data do you need to do it?
Value-based arrangements are as diverse as the names they go by. No matter what you call it, as payment models move from volume to value, continued success will be directly influenced by your ability to harness data to answer questions like these and make informed decisions.
Whether it's a value-based purcahsing (VBP), pay-for-performance, shared savings, capitation or risk, ACO, bundled payment, quality incentives, or any other kind of value-based reimbursement, all entities face the same struggles: they need to use and understand data.
We understand it from all sides.
How Versatile helps:
1. Identify measures that make sense for you based on your performance.
2. Model new measure impact on your bottom line - is it even worth it?
3. Liaise between payer and provider to define data specifications and validate data exchanged.
4. Help our providers regularly validate, use and understand payer claim/episode data.
5. Develop reporting or KPIs for on-going tracking to your level of comfort and readiness.
6. Use your existing vendor platforms or build internal tools to monitor, identify new opportunities, and guide.
Even simple views of your performance can help immensely.
Here's a simple example (built on a client's internal system with Tableau):
We want to see entities thrive and collaboration increase under these new payment models.
As a provider, you need to know what you're agreeing to, how it will affect your bottom line, how to manage your patients at point-of-care with these arrangements in mind, and regularly monitor your progress towards meeting your targets. You'll want to assure that you're maximizing incentives and being reimbursed accordingly. You need to manage and validate the disparate data every Payer is providing you, develop targeted workflows and initiatives to bend the curve, and have a feedback loop for both your practitioners and your payers. Depending on the arrangement, you may even need to start "thinking like a payer" in terms of managing the cost curve.
As a payer / employer group / contract administrator, you need to develop effective VBP arrangements & improvement goals that will bend the curve, are identifiable, obtainable, reportable, and easy to administer. You need to be able to profile your Providers and identify areas of opportunities and partnerships that will have an impact. You need to be able to measure this, set baselines, and provide actionable information to the providers whom you enter these arrangements with. You need to be able to respond to data inquiries and measure success, working together to bridge any gaps.
Where are you losing out on bonus revenue
or performance opportunities?
Let us look.
Already have a population health tool or solution implemented? No matter what your VBP arrangements are, or what tools & products you may have already implemented, we can jump in to extract insights that are meaningful to you and the unique arrangements that you have when you need them.
Standing up something like this? We serve as provider-to-payer representatives and technical liaisons for new and on-going arrangements. We also serve as technical SME for clients who are implementing population health tools and need experienced resources to recommend/gather/direct requirements & functional design elements with their best interest in mind. Check out our Implementation Offerings.
No plans to purchase a pricey solution? We can design & develop new dashboards or reports for your needs, with your data - no expensive vendor tools needed, and at any level of reporting/data sophistication. In the example above, Tableau was used to build a monitoring tool for specific ACO performance measures.