Why contract management is crucial for ACOs, risk-bearing providers in VBC
April 08, 2024
Business Affairs
• Management of referral workflows to reduce leakage
• Alignment and coordination of primary and specialty care
• Assessment, automation and administration of business processes and workflows within structured programs
A many-to-many network infrastructure
While legacy infrastructures may have been capable of supporting relatively simple fee for service (FFS) contracts, they are incapable of supporting the type of complex networks with multiple stakeholders typical of an ACO or other risk-bearing entity.
To attain shared savings and avoid shared costs under a VBC contract, ACOs and other risk-bearing organizations need a scalable, cloud-based digital infrastructure that enables a many-to-many network of participants. This can include Community-based Organizations (CBOs), some of which lack adequate digital capabilities but expect frictionless reimbursement for services under the terms of an ACO agreement.
Conclusion
The operational efficiency of ACOs and other risk-bearers depends on scalable digital infrastructure that can handle the demands of a many-to-many collaborative care network. The right digital infrastructure could support a network of multiple stakeholders, including payers, hospitals and physician groups, social service agencies, and CBOs.
To be successful, risk-bearing providers need to focus their resources on improving patient and population health outcomes while controlling costs. A powerful analytics platform along with strong operational capabilities running on top of a scalable digital infrastructure can serve as the foundation for a data and networking framework that supports the success of VBC contracts.
About the author: Lynn Carroll is the chief operating officer of HSBlox and David Wolf vice president, product management at MedeAnalytics.
Back to HCB News
• Alignment and coordination of primary and specialty care
• Assessment, automation and administration of business processes and workflows within structured programs
A many-to-many network infrastructure
While legacy infrastructures may have been capable of supporting relatively simple fee for service (FFS) contracts, they are incapable of supporting the type of complex networks with multiple stakeholders typical of an ACO or other risk-bearing entity.
To attain shared savings and avoid shared costs under a VBC contract, ACOs and other risk-bearing organizations need a scalable, cloud-based digital infrastructure that enables a many-to-many network of participants. This can include Community-based Organizations (CBOs), some of which lack adequate digital capabilities but expect frictionless reimbursement for services under the terms of an ACO agreement.
Conclusion
The operational efficiency of ACOs and other risk-bearers depends on scalable digital infrastructure that can handle the demands of a many-to-many collaborative care network. The right digital infrastructure could support a network of multiple stakeholders, including payers, hospitals and physician groups, social service agencies, and CBOs.
To be successful, risk-bearing providers need to focus their resources on improving patient and population health outcomes while controlling costs. A powerful analytics platform along with strong operational capabilities running on top of a scalable digital infrastructure can serve as the foundation for a data and networking framework that supports the success of VBC contracts.
About the author: Lynn Carroll is the chief operating officer of HSBlox and David Wolf vice president, product management at MedeAnalytics.
Back to HCB News
You Must Be Logged In To Post A CommentRegisterRegistration is Free and Easy. Enjoy the benefits of The World's Leading New & Used Medical Equipment Marketplace. Register Now! |
|
