Navigating the Waters from Volume to Value: How to Succeed in Value-Based Models
To successfully shift from volume to value-based payment models, providers must embrace new operational and financial skills to strategically navigate healthcare risk-based arrangements. This is especially true for health systems sponsoring health plans and assuming an increasing amount of risk.
Providers looking to stand up a health plan, including a Medicare Advantage plan, require expertise in a variety of areas to ensure a return on their investment. Essential skills include the ability to align physician incentives with cost and quality goals, transform care delivery, develop the care management expertise traditionally associated with payers, and provide actionable data to physicians to drive clinical and financial performance.
Developing these capabilities requires commitment, behavior change and investment. An experienced operational and financial partner can help a health system make the transition and effectively manage risk to more quickly realize an ROI.