Surviving and thriving under hybrid reimbursement models

In a new 3-part series, Corrina Kane, our Head of Strategic Marketing, investigates the pursuit and real-life application of value-based care in the US healthcare market. Interviewing a range of leading executives across the provider and payer ecosystem, she looks to uncover how value-based care is being practiced and developed on the ground, and the challenges of improving quality of care in an environment of cost reduction.

In part 1, we address the difficulties providers face in the long period of transition from fee-for-service to value-based reimbursements, and identify strategies to thrive in this hybrid world.

Surviving and thriving under hybrid reimbursement models

Regardless of current political uncertainties, and federal agency backtracking on implementation of bundled payments, no-one is in doubt that value-based care and reimbursement is the future of the healthcare system. By its very nature, this new way of delivering and paying for healthcare is the antithesis of the old world of fee-for-service and payment for activity. As with all system change, there are winners and losers. As in nature, hybrids are commonly less viable than their parent species. Those surviving are operating in increasingly commoditized markets with high fixed costs in an environment of reduced reimbursement. Many are having to find creative ways of delivering care whilst maintaining profitability and offsetting reduced margin by cutting back on operational costs to stay in business. The fittest are thriving. Those with innovative, forward-thinking and well-resourced leadership have been investing ahead of the curve and are implementing a host of transformations to be successful in the new world. Some common characteristics include: rethinking care delivery models, infrastructure change, managing care at a population level and leveraging data and technology to reduce operational and administrative burden and implement new ways of working. This article explores case studies of organizations thriving in value-based transition and how they’re achieving success.

To read the full article in Beckers CFO Report please click here.

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