Embrace the new reimbursement landscape

The transition from a fee-for-service to pay-for-value reimbursement model is one of the largest challenges facing the U.S. healthcare system. Significant reimbursement targets are already approaching. By 2018, 50 percent of healthcare payments will be tied to alternative payment models, and 90 percent will be tied to quality or value.

Regardless of your MACRA/MIPS strategy, involvement in ACOs, owned health plan, or other value-based contracts, to succeed in this evolving environment, you must navigate new challenges for sharing and analyzing data while keeping your focus on the quadruple aim: quality outcomes, patient experience, cost, and provider satisfaction.

We help you transform your organization — and your EHR — to adapt to the changing industry. Our value-based reimbursement services blend advisory guidance and hands-on technical expertise, and we work closely with you to understand the needs of your patient population and tailor a value-based system designed to maximize reimbursement and quality of care.

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Understand your patient population

The first step to navigating the evolving value-based reimbursement environment is understanding your patient population and their needs. Healthcare is becoming more transparent each day, transforming patients into conscious consumers armed with choice and decision-making power. Maintaining stable reimbursement while keeping patients happy and healthy requires deep insight into your population — and the tools to share that information with other providers to support decision-making.

We help you discover your patient population’s most pressing needs and tailor a value-based strategy accordingly. You’ll receive a complete picture of your patients’ needs, including problems, conditions, ongoing care, geographic locations, care mediums, and socioeconomic factors — the foundational data points that enable you to make smart, informed decisions with every new initiative.

Strategize and engage key stakeholders

Beyond understanding your patient’s conditions and needs, we help you understand your reimbursement drivers and work with your leadership team to align organizational priorities and stakeholders. Using your current organizational governance and project backlog as a starting point, we can help prioritize operational and system updates that will have the greatest impact. Our advisory team meticulously refines your current operations, processes, payer contracts, and competencies while driving collaboration and communication with key stakeholders to fuel successful outcomes in the value-based reimbursement environment.

Tune your EHR for longitudinal care

Performance Monitoring

  • Data warehouse
  • Benchmarking data
  • Dashboard reports
    • Finance
    • Clinical

Patient Management

  • Patient stratification registries
  • Application reporting tools
  • Patient lists
  • HIE data aggregation
  • Patient care and outcome metrics

Clinical visits

  • Discrete clinical documentation
  • Clinical decision support and alerts
  • Evidence-based practice
  • Order sets
  • Care plans
  • Patient education
  • Discharge planning & care management
  • Telehealth visits
  • Risk dashboards

Patient Outreach

  • Patient portal notifications and messaging
  • Automated mailers
  • Social media
  • Questionnaires
  • Longitudinal plan of care

Outcome reporting

  • QRDA reporting
  • Coding
  • Quality improvement tools
  • Registries

Set the stage for quality measure performance

Quality measure performance is a critical underlying aspect to all value-based reimbursement programs. We can meet your organization wherever you are in your journey, whether it’s determining which measures to report, assessing your performance, optimizing your EHR for improved measure performance and workflow efficiency, or submitting your measures.

Learn about our quality measure solutions

Achieve short- and long-term results

Short Term

  • Maximize reimbursement from payers
    • Medicare Advantage
    • Performance-based commercial contracts
  • Ensure high performance on quality measures
    • Focus effort on measures that meet multiple value-based initiatives
    • PQRS, MU, readmissions
  • Position stakeholders for success and develop supporting technology and analytics
    • Clinical documentation improvement
    • Care management

Long Term

  • Evaluate opportunities to reduce costs while still maintaining recognition
  • Extend to regional affiliates and strengthen relationships with referring providers
  • Use data, analytics, and patient portals to stratify and engage patient population
  • Assess and achieve performance in Alternative Payment Models

Set the stage for value-based success throughout your organization.