Value-Based Payment

Value-Based Payment

To succeed in value-based payment models, providers must approach contracts strategically, engage physicians, use the right data analysis tools, design meaningful care improvements, track performance, and then do it all over again.

Veralon can help you implement and execute successful value-based payment programs. We can analyze and optimize performance in a single contract, or support multiple contracts simultaneously, helping your organization gain confidence and financial stability.

Veralon’s BPCI clients have been successful in achieving overall average savings of 15%, by reducing readmissions by up to 45%, and decreasing SNF stays up to 30%.

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We can assist your organization with:

Designing shared savings or risk-sharing arrangements:

  • Structuring and negotiating contracts to achieve the benefits of aligned interests
  • Analyzing current population health costs across the continuum of care for the population using your participating primary care physicians
  • Projecting feasible savings and the amount that will accrue to the risk-sharing entity
  • Estimating the impact on utilization and the bottom-line
  • Determining bonus pool distribution and physician incentive payment mechanisms

Optimizing performance under bundled payment:

Veralon will help you identify savings opportunities and how to pursue them, using Quanto. We can check and reconcile final payment/savings computations prepared by CMS or by health plans.

  • Determining which bundles are improvement priorities
  • Analyzing the impact of different care pathways
  • Assessing the effectiveness of physicians and post-acute care providers
  • Selecting the best participants for your post-acute care network
  • Segmenting readmissions
  • Developing physician gain sharing models to drive improvement

All of these value-based payment mechanisms require a data infrastructure that can support performance monitoring and incentive payments. Quanto allows us to meet the needs of ACOs and bundled payment clients; for other forms of value-based payment we can identify the data required and sources to obtain it.

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