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Attendees of the Cornerstone Summit on Population Health Managment had the goal to identify strategic and operational barriers to success in value-based reimbursement and potential solutions for achie

Answering the question “is our population health program successful?” is difficult. It’s next to impossible if we can’t answer, “what should our population health program drive toward?” first.

In 2017, the Population Health Summit accomplished some key milestones for the development of PHM by establishing best practices for both providers and vendors.

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PHM Downside Risk 2021

14 October 21 | Bradley Hunter and Cathy McCabe

In the United States, just 10% of the average healthcare organization’s revenue comes from downside risk contracts. However, several health systems are ahead of the curve, and their valuable insights on adopting downside risk can help peers figure out how to move the needle on value-based reimbursement (VBR). KLAS worked with population health management (PHM) vendors to identify which of their customers are most advanced in adoption of downside risk contracts and then conducted interviews with top executives at 15 of these organizations. We spoke with large, midsize, and small health systems as well as a handful of ACOs, highlighting the fact that with the right technology and organizational structure and buy-in, organizations of all types can make significant progress toward VBR. The Executive Insights portion of this report explores what outcomes the organizations have achieved as well as their aggregated insights regarding keys to success, lessons learned, and potential pitfalls. Case studies for each of the participating organizations provide additional detail and can be found in the Expanded Insights section of the report.

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