Value-Based Care Managed Services Services Product Ranking Comparison

Value-Based Care Managed Services

Ongoing managed services that help hospitals, health systems, payers, and physicians more effectively manage patient populations and transition to value-based care and alternative payment models. Vendors in this segment offer a broad and often complete suite of solutions, including software and ongoing services, and typically do so on a long-term contract basis. Examples of VBC managed services include administrative services (network management, analytics as a service, risk adjustment services, etc.), clinical services (care management, care coordination, disease management, patient education), and financial services (health plan administration, member services, claims processing, PBM, benefits management, etc.).

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Inpatient treatment for high-risk cardiovascular patients comes with a significant cost for patients, providers, and payers. Costs are lower and outcomes are better when the care for these patients is effectively managed outside the hospital. To achieve this, the collaborators in this case study combined payer and provider data to better predict costs and patient outcomes and then established a bundled payment contract that reduces the costs of caring for patients with high-risk cardiovascular diseases while ensuring they receive the care appropriate for their condition. Outcomes include reduced hospitalization and lower costs.

The collaborators in this case study noted that some patient populations were completing preventive annual health assessments at lower levels than other populations. To address this disparity and help clinics close care gaps at the point of care, the collaborators implemented a program aimed at incentivizing frontline staff and physicians on a monthly basis for time spent addressing open care gaps. As a result of the program, the participants have seen improved gap closure, improved performance in quality measures, improved coding accuracy, and higher staff morale and engagement.

Point of Light

Points of Light 2023 Case Study 17

14 April 23 | Aurene Wilford and Boyd Stewart

Vulnerable and underserved populations face a variety of barriers that can make it difficult for them to adhere to their prescribed medication regimens, and the impacts of non-adherence—in terms of health outcomes and costs—can be severe. Low medication adherence was a particular problem for the healthcare organization in this case study, whose patient population covers one of the most vulnerable and underserved zip codes in the country. To encourage better adherence among high-risk individuals, this organization collaborated with a payer organization and value-based care partner to identify patients in need of additional support and help resolve their barriers to adherence. Results include better health outcomes and higher CMS Star ratings.

Inefficient care transitions lead to wasted time and energy, increased risk of human error, and potentially poor experiences for both patients and providers. Despite the industry’s attempts to ensure the right information is sent to the right people at the right time, healthcare organizations must often revert to manual processes for data entry, verification, and communication. Some organizations use or want to use technology to streamline their transitions of care (TOC). This report—KLAS’ first to look at TOC—draws from the perspectives of 95 healthcare leaders across multiple care settings to understand their adoption of care transition technology, the challenges they encounter in their care settings, and the vendors they are considering.

Value-Based Care Managed Services

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Performance Data

Overall Score by Product

Overall Score by Question Topic

Provider Facility Size by Product

Provider Facility Type by Product

Reducing Filters

Value-Based Care Managed Services

If you don't have a login, getting started is easy.

Performance Data

Overall Score by Product

Overall Score by Question Topic

Provider Facility Size by Product

Provider Facility Type by Product

Reducing Filters

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