Value-Based Care Strategy
Succeeding in value-driven payment models requires fresh insights and new perspectives that enable organizations to break from the historical fee-for-service paradigm while building on expertise and capabilities already in place.
In an industry where economic models are increasingly rewarding alignment with the premium dollar, organizations that can update their business model in strategic and pointed areas will increasingly be rewarded with opportunities. A successful value-based care (VBC) strategy aligns an organization’s capabilities to create value with its economic models to capture value.
Sg2 Areas of Expertise
Sg2 leverages its expertise in organizational partnerships to drive success in VBC through custom strategies and structures that enable organizations to capitalize on new opportunities for creating and capturing value across all payer classes.
► Positioning and Enablement
- Network adequacy and design
- Clinically integrated networks
- Independent practice associations
- Physician hospital organizations
- Foundations and collaborations
► Value Creation
Clinical Model and Competencies
- System of CARE Redesign
- Enterprise capabilities and competencies
- Quality and outcomes alignment
- Care management, including disease and episode-based
- Incentive design and funds flow
► Value Capture
- Strategic roadmap and prioritization
- Financial modeling
- Program and contract evaluation
- Contracting arrangement terms
- Downside risk mitigation
- VBC Partnerships
Payers: Medicare, Medicare Advantage, Medicaid, Commercial, Direct to Employer
Payment Models: Accountable care organizations, episodes, bundles, capitation, provider-sponsored health plans/cobranding
Value-based Care Organizational Assessment
Our Core Competencies assessment provides a proprietary framework for evaluating an organization’s VBC infrastructure capabilities and gaps against the Triple Aim goals of:
- Improving population health
- Enhancing patient experience and outcomes
- Bending the health care cost curve
Enhancing Oncology Model (EOM): EOM aims to enhance the quality of care provided to cancer patients covered under Medicare Traditional while reducing Medicare fee-for-service expenditures. Learn more about EOM.
ACO REACH (Realizing Equity, Access, and Community Health): ACO REACH is the redesigned and renamed Direct Contracting (DC) model. Similar to its predecessor, ACO REACH is designed with two risk-sharing options in mind and focuses on empowering beneficiaries, reducing provider burden and accelerating risk assumption. Learn more about ACO REACH.
The Medicare Advantage landscape is rapidly evolving
Trends in Medicare Advantage (MA) ripple through the healthcare industry, impacting stakeholders differently and having a direct impact to your healthcare financing and care delivery models. Knowing these trends and how they are playing out in your market is paramount to building successful strategies in a complex landscape.
That is why we have developed our Medicare Advantage Insights Tool, which provides updated trends and insights using MA plan and enrollment data. Understanding the MA trends occurring in your service area can help you begin to formulate a strategic response.
Dive deeper into how Sg2 can help your organization:
- Blog Post: Will 2023 Be the Year That You Fully Embrace Value-Based Care?
- Blog Post: Why Start Now? Care at Home Provides Value Beyond Cost Savings
- Blog Post: Taking an All-Patient Approach to Advancing Health Equity
- Blog post: Value-Based Care Economics Are More Compatible With Fee-for-Service Models Than You Realize
- Blog post: It’s Time for Providers to Reevaluate Clinical and Economic Models for Value-Based Care
- Blog post: Benefits of Launching Direct-to-Employer Services to Your Health System Employees
- Blog post: Struggles with Direct-to-Employer Engagement and What Health Systems Can Learn from the Pockets of Success
- Podcast: Direct-to-Employer Strategies: Helping Employers Achieve Better Value
- Podcast: CINs as a Strategic Approach to Managing Triple Aim Goals
Senior Principal, Sg2 Consulting
Associate Principal, Sg2 Consulting
Principal, Sg2 Consulting
Associate Principal, Sg2 Consulting