Executive Summary: How to combine risk and quality: Secrets from the pros

Historically, risk adjustment and membership growth have been the largest revenue levers for government program payers. But that’s evolving. Due to a shifting regulatory landscape, the quality bonus payment is an important new revenue lever.

Advertisement

Just as health plans are growing by maximizing quality bonuses, providers are seeking new ways to grow through value-based care. In moving to this model, it’s increasingly important for providers to view payers as strategic partners to have the data that drives visibility into the value they deliver.

In How to combine risk and quality: Secrets from the pros, you’ll learn what it takes for payers and providers to collaborate in the era of value-based care. As you analyze your own organization’s journey, you’ll want to assess your capabilities in four areas:

  • Infrastructure: having the technology in place to enable real-time analytics
  • Interventions: measuring efficacy and avoiding member abrasion
  • Field resources: engaging clinicians to address gaps in care
  • Data acquisition: leveraging EMR data with predictive models

Click here to download Optum’s Executive Summary and learn more!

 

 

News From Our Partners.

At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.

Advertisement

Next Up in Payer

Advertisement

Comments are closed.