Value-Based Healthcare Solutions
Value-based care is a healthcare delivery model that bases provider compensation on patient health outcomes rather than total volume of services delivered, incentivizing high quality of care and cost efficiency while improving patient outcomes.
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Helping Providers Succeed in Value-Based Care Models
Alternative Payment Models (APMs) differ from the traditional fee-for-service (FFS) approach, in which healthcare providers are paid primarily based on the volume of services they deliver, regardless of patient outcomes. The transition from FFS to value-based care is critical to ensure continued delivery of high-quality, cost-effective care and has become one of the largest drivers of change within the healthcare industry.
Your Partner in Value-Based Healthcare
The Centers for Medicare & Medicaid Services (CMS) as well as commercial payers are rapidly introducing Alternative Payment Models, like value-based care, to shift financial risk onto providers, to incentivize improved quality and more cost-efficient delivery of care.
The Alliant value-based healthcare practice is exclusively focused on helping providers succeed as they shift from fee-for-service to Alternative Payment Models. Through our value-based care focused risk management, analytics, and strategic solutions, our partnership with provider organizations empowers them to thrive in a rapidly changing healthcare environment.
A Dedicated Value-Based Care Practice for the Healthcare Industry
Our team includes reinsurance and risk management experts, data scientists, FSA-credentialed actuaries, clinicians, and compliance attorneys on staff who are dedicated to helping healthcare organizations develop better informed decision-making and optimize their outcomes in value-based care. Alliant works with a variety of entities in the healthcare space, including:
- Accountable Care Organizations (ACOs)
- Providers in Capitated Risk Contracts
- Medicare Advantage (MA) Plans
- Medicaid Value-Based Care Models (1115 Waivers, etc.)
- HMOs and Health Plans
- All CMS/CMMI Value-Based Care Models
A Strategic Approach to Value-Based Care
Our approach to value-based care which includes risk management, analytics, and strategic considerations allows you to stay ahead of the curve. Alliant supports our clients in the following key areas:
- Reinsurance/Stop Loss Optimization
- Financial Guarantee Requirements
- Actuarial Modeling
- Program Benchmark Development
- Peer Benchmarking and Comparisons
- Data Warehousing
- Compliance/Rulemaking
- Captive Feasibility & Expertise
- Performance Analytics
- Consulting: Actuarial, Clinical, Operational
Tailored Value-Based Care Offerings
Through extensive knowledge of the changing trends and challenges within the value-based care space, the Alliant value-based healthcare team is uniquely positioned to meet the needs of healthcare providers. Every provider participating in value-based care models is different and has unique needs. We tailor solutions that are customized to each client and their respective market, to help them maximize performance and deliver high-quality, cost-efficient care.
Analytics Insights for Value-Based Care
Understanding your own data is a critical piece to succeeding in healthcare delivery. Our analytics insights for value-based care models help providers improve financial performance and quality against their total benchmark or target price. By highlighting high performing areas and areas for improvement, we enable providers to perform better in their respective risk contracts and create savings opportunities while continuously improving delivery of care.
Value-Based Care Insurance Offerings
We provide the following tools to help you measure and improve performance:
- Pricing and Opportunity Assessments
- Real Time Performance Tracking
- Peer Benchmarking
- Data Warehousing
- Episode Analyses
- Custom Client Portal
In the current healthcare regulatory environment, it is critical to stay up to speed on program-specific compliance regulations and policy updates. Alliant supports our clients in the following areas:
- Subject Matter Expertise
- CMS Program Guidance
- Application and Eligibility Support
- Advocacy
- Rulemaking Updates
Our VBC-focused risk management services include:
- Financial Guarantee Requirements
- Reinsurance/Stop Loss Optimization
- Specific & Aggregate Stop Loss
- Actuarial Modeling
- Captive Feasibility & Expertise
- Capital Relief Transactions
- Reserve Requirements and Analysis
- Carrier Negotiations and Relationship Management
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