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.
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: Look Beyond MSSP Policy Changes for Long-term Success in Value-Based Care, and related video series, Sg2 Experts Explain Changes to the Medicare Shared Savings Program
- 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: MSSP Season Is Here! Should You Participate, and if You Participate, Are You Prepared for Downside Risk?
- Blog post: ACO REACH Is Here! How Will It Impact Your Value-Based Care Strategy?
- Blog post: Direct-to-Employer Contracting: Understanding the Value of “Value”
- Podcast: Direct-to-Employer Strategies: Helping Employers Achieve Better Value
Request more information or to speak with an Sg2 value-based care expert.
Tawnya Bosko, DHA, PhD
Senior Principal, Sg2 Consulting
Keely Macmillan, MS
Associate Principal, Sg2 Consulting
Joe Maher, CPA, MBA
Associate Principal, Sg2 Consulting
William Ringwood, MBA
Senior Director, Sg2 Consulting