Value-Based Care: Managing Operations & Care While Assuming Risk
With an emphasis on improving clinical and operational outcomes, the transition to value-based care is transforming care delivery with increased focus on population health management. Reimbursement models have yet to keep pace, with many organizations still balancing between fee for service models and value-based contracts. Across the country, hospitals and health systems have expanded the number of lives in existing risk-based contracts, as well as increased the number of health systems participating in risk-based arrangements. Succeeding under these arrangements requires consistently monitoring individuals’ health, proactively preventing illness or catching chronic conditions at an earlier stage, among other things. This executive dialogue focuses on how organizations are managing risk, particularly under the accountable care organization (ACO) and clinically integrated network (CIN) models. It also explores current and potential barriers to success under risk-based contracts, as well as key success factors for building sustainable change.