For operational efficiency, value-based initiatives need a scalable digital infrastructure that can handle multiple reimbursement models, including fee for service. Value-based care (VBC) models are designed to improve patient outcomes and reduce healthcare costs by proactively focusing on patient wellness. This preventive approach to individual and population care requires collaboration between patients, providers, payers, and other stakeholders, such as community-based organizations (CBOs) that offer wellness-related services.
The operational efficiency of payer VBC initiatives is dependent on a scalable digital infrastructure that can handle multiple reimbursement models, including FFS, and facilitate multiple payment streams. Such a digital infrastructure should enable a network of multiple stakeholders, which may include payers, hospitals and physician groups, social service agencies and community-based organizations.
When payers combine powerful analytics with strong operational capabilities on top of a scalable digital infrastructure, they create a data and networking framework that supports the success of VBC contracts and improves network performance.
Lynn Carroll (COO of HSBlox) and David Wolf (AVP of Product at MedeAnalytics) talk about how to scale contract management in a Value Based Care Programs.
