directions

Perspectives

Enabling care model transformation and redesign

Improve efficiency, outcomes, and the patient-clinician experience

As health care provider organizations increasingly pursue value-based care business models and contracts, it’s critical to efficiently manage total cost while delivering high-quality care. Learn how care model transformation can help players in the space accomplish these objectives. Our four-part blog series explores the future of care management, common challenges, success factors, and the key benefits, design elements, and technologies needed to be successful in value-based arrangements.

Part 1: Why provider organizations need to spend more time on integrated care management

Many health care provider organizations are turning to value-based care (VBC) business models and contracts in response to cost pressures, fee-for-service model shortcomings, federal policies and regulations, and consumer expectations. These new payment models tie reimbursement to outcomes and align incentives around reducing the total cost of care. Payers are currently in hot pursuit of more robust and substantive partnerships with providers. Success depends on the ability of health systems to effectively manage population health risks while delivering high-quality care and growing the number of patients attributed to these contracts.

The COVID-19 pandemic has exposed fee-for-service model shortcomings leading to delivery model changes and improvements, as well as the increased adoption of digital and virtual solutions. Virtual care and telehealth usage is commonplace, helping to reorient care delivery to prioritize consumers’ preferences. In addition to providing convenient ways for patients to engage with health systems, virtual health presents health care organizations with compelling new opportunities to gain data-driven insights on their patients and connect patients to optimal clinical resources.

Learn more about efficiently managing the total cost of care, why technology and data matter, and how we can help your company modernize patient engagement in our first blog post on care model transformation and the future of integrated care management.

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