Value-Based Care Transformation

The incentive model for health systems is changing with a shift toward value-based payment models. The opportunity—to reduce cost of care and improve quality of care—is great. But the challenge—adopting new incentive models and accepting the correlative financial risk—is real.

As health systems navigate this shift, they struggle with risk readiness when evaluating taking on value-based payment models. Even if the system understands their risk readiness, and has taken on some value-based structures, fee-for-service must still be accounted for. The reality? A need for significant change management efforts.

Operational changes will also drive a need for a cultural shift given the current relationship between providers and executives/administrators, as well as payers and providers. It’s important for health systems to leverage data analytics when designing processes that support the shift to value-based care to ensure efficiencies and cost effectiveness.

That’s where we come in.

Results You Can Expect

• Drive better outcomes for your patients, payers, employer group partners, and your own health system through improved clinical processes
• Boost profitability through unique and evolving value-based contracts that enhance quality, safety, population, and community health while lowering the cost of care
• Enhance productivity through systems integration and process automation

What We Offer

Bundled payment readiness assessment & implementation

We enable business processes and clinical operations to capitalize on risk-based contracts, migrate toward risk-based care delivery, and achieve clinical integration to support high-quality care delivery at a lower cost. Bundled payment readiness is an essential factor in that equation. How can you develop and operationalize a bundled payment strategy that effectively monitors claims data utilization and quality, supports collaboration within your provider network, and integrates with existing systems? West Monroe can help.

Digital analytics transformation

Having a lot of data is good—if you are able to use it. With an increase in value-based care analytics vendors in the market, it can be difficult to know where to begin. We take an undeniably different approach to digital transformation analytics – one that delivers difference-making insights now. Powered by Intellio® DataOps, our proprietary platform handles the complexities of data collection, preparation, and management behind the scenes. That means you can focus on using insights to drive immediate value: lower costs, top-line growth, and better health outcomes with the aid of data-driven incentives for the delivery of low-cost, high-quality care. 

Change management process flow

As value-based contributions to healthcare spend continue to grow, providers must shift to getting paid for value/outcomes vs. procedures/volume. Becoming an outcomes-driven organization can be a cultural hurdle requiring a comprehensive change management process, but in the face of rising cost and quality concerns, change is increasingly necessary. Our change management assessment, roadmapping, and support services help your organization navigate the shift.

System integration/development

Cut down on the manual work required to synchronize disparate systems with our system solution assessment and roadmapping, development, and system integration management services. We help you create a robust data system that enables the identification of high-risk populations, evaluates cost savings and performance, and supports the development of a strong post-acute network.