Premium Reports
Value-Based Reimbursement

Value-Based Reimbursement
Making the Shift, Who Can Help?

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A provider’s first step in choosing the right firm is to weigh their needs versus a firm’s capabilities. Such engagements reflect the complexity and uniqueness of each organization’s individual trajectory; firms are trying to bring a consistent set of methodologies and processes to an inconsistent market. Therefore, providers are faced with the difficult first task of evaluating firm options based on a cross-section of competing needs.

FIRM DNA & PERFORMANCE

1. ADVISORY BOARD AND LUMERIS DELIVER ON TRIPLE AIM

After identifying potential firms to support CLIENT-REPORTED IMPACT their VBC transformation, providers need to feel confident in their progress toward their Triple Aim objectives. 100% of Advisory Board clients report a high impact across these objectives, citing a proven reputation for physician engagement and building CINs. Lumeris helps providers reimagine patient care by building a complete patient profile. Valence Health empowers clients to operationalize clinical integration and provider-sponsored health plans. Premier’s collaboratives model connects providers to a community through which they can facilitate and build VBC programs.

CLIENT-REPORTED IMPACT

2. ADVISORY BOARD, CONIFER, AND EVOLENT HEALTH ARE MOST HELPFUL IN PREPARING FOR FUTURE RISK

Providers also evaluate firms based on their demonstrated ability to prepare organizations for evolving alternative payment models. Advisory Board engenders universal client confidence by supporting governance and infrastructure development. All of Conifer’s reporting clients feel empowered from having been taught to use data to strategically plan for risk-bearing contracts. Evolent’s ability to help providers understand the market leads to high confidence in taking risk.

3. PREMIER AND ADVISORY BOARD LEAD VBC CONSULTING SERVICES

After identifying potential matches, providers can consider firm performance. Premier succeeds in delivering detailed governance-structure planning and leadership development; however, insufficient resources is a noted concern. Advisory Board performs well by promoting physician leadership to create CINs that better position clients for managing population health, although a high price tag can result in a diminished sense of value for clients. PwC’s lower performance in an array of strategy work reflects some providers’ concerns that PwC’s boiler-plate approach can cause a disconnect between PwC’s performance and providers’ goals.

VALUE-BASED CARE CONSULTING SERVICES

4. VALENCE HEALTH AND LUMERIS ARE HIGHEST PERFORMING IN VBC MANAGED SERVICES

Although some firms claim to be a “one-stop shop,” providers who are evaluating options for ongoing support find each firm demonstrates areas of specialty. Lumeris improves providers’ understanding of patients, although a focus on Blue Cross Medicare Advantage populations constrains payer relationships. Valence Health demonstrates deep knowledge through their TPA background and strong analytics capabilities while exhibiting limitations with clinical data aggregation. Through strong partnerships, Evolent clients experience enhanced care coordination and reimbursement management services but also note issues with immature technology. Although Conifer excels at identifying and engaging patient populations, their low client satisfaction reflects stretched resources that in some engagements have resulted in slowerthan- expected responses to client needs.

VALUE-BASED CARE MANAGED SERVICES

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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2018 KLAS Enterprises, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.