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Value-Based Contracting 101: Preparing, Negotiating, and Succeeding

Value-Based Contracting 101: Preparing, Negotiating, and Succeeding

June 1, 2021Jacqueline LaPointeNo CommentsRevCycle IntelligenceClinician Engagement & Education,Next Generation ACOs,Medicare, MA, MSSP, & Medicare ACOs,VBC Development, Growth & Expansion,Direct Contracting, Direct Contracting Entities (DCEs),Payers, Plans, & Claims,Contracts, contract management

The Triple Aim. The Quadruple Aim. Right care at the right place at the right time. Whether one works in a hospital or small independent practice, healthcare providers are leaning on these concepts to deliver valuable care to their patients, and that is in its simplest form: care that results in the best patient outcomes at the lowest possible cost to the patient and the system.

And for the most part, provider organizations have already established the infrastructure and workflows to support this value-based care. Perhaps they have hired additional staff to coordinate discharges or transitions of care, implemented data analytics solutions to prevent chronic conditions, or taking a couple of extra minutes during a routine exam to ask about a patient’s access to healthy food, transportation, and safe lodging.

But the value added by these actions—and the better outcomes they have produced—are not necessarily aligning with the contracts most organizations have with payers to finance care.

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: contracting, Fee for service, MSSP, negotiating, negotiations, Next Generation ACOs, payer-provider collaboration, Payers, Physician Engagement, Value based contracts, value-based care

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