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.