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Key Characteristics for Successful Downside Risk Contracting

Key Characteristics for Successful Downside Risk Contracting

October 15, 2021Erin McNemar, MPANo CommentsRevCycleIntelligenceRisk Management,Risk Stratification

Organizations that do strong vendor relationships, invest in the organization, and are willing to take on commercial risk will be poised to take on downside risk financial contracts. Through working with population health management vendors, KLAS released a recent report identifying which of their customers are most advanced in adopting downside risk contracts.

In the United States, only 10 percent of the average healthcare organization’s revenue comes from downside risk contracts. However, KLAS discovered that several health systems are beginning to pursue this revenue option, and their insights on adopting downside risk could assist others in improving value-based reimbursement (VBR).

KLAS conducted interviews with the top executives at 15 organizations, speaking with large, midsized, and small health systems as well as some accountable care organizations (ACOs). The report highlights that with the right technology, organizational structure, and buy-in, organizations of all types can advance value-based reimbursement.

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: contracting, downside risk contracting, healthcare payers, KLAS, Payers, Population Health, Population Health Management, Risk, risk contracting, risk management, value-baed reimbursement, value-based care, value-based contracting, VBR

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