The move to Value Based Payment (VBP) involves structuring and formalizing services into a continuum and weighing the treatment outcomes to performance requirements with known risks and costs. Preparation for entering into a VBP agreement involves a deep knowledge and ability to analyze and communicate about: clinical and demographic service population; risks to overall care, risks to episodes of care and risks to required outcome reporting; operational cost of care; projected cost savings to delivery system based on provider performance and lowered population risk; service definition in the bundled payment methodology; metrics definition for performance reporting; and, revenue management with strong manage care engagement and contracting. Metrics definition is essential to link services, outcome, risk and cost at a macro level with the ability to drill down to episodes of care and projected cost savings. A quality improvement and oversight mechanism to track successes and vulnerabilities must be built into the metrics definition and allow for corrective actions and process change because a VBP arrangement is a continuously active and dynamic evaluation of outcome and services.
The implementation of a new service model is a transformative growth opportunity. It is a time to refine existing Agency infrastructures that can transform the practice of care delivery, address shifts in the business model and identify changes in revenue management and quality improvements. SAE can assist with all levels of Agency Transformations with a Rapid Assessment, Implementation and Service Launch, and Initial Monitoring of new service model changes.