From Volume to Value: Are You Ready?
Value-based reimbursement and the Accountable Care Organization (ACO) model are no longer on the horizon – they are a very real force in U.S. healthcare today.
The very definition of Accountable Care Organization has changed. Today, the term can be applied to define any organization – government, private or commercial – that manages the full continuum of care for defined populations and that reimburses providers according to value-based metrics. The key challenge for health care leaders is to remain viable in the current reimbursement climate that continues to maintain a fee-for-service model while embracing value-based reimbursement.
Learn how McKesson can help.
Risks and Rewards
Although the move to value-based reimbursement can lead to better clinical outcomes for patients and improved financial performance for physicians, success is not guaranteed. The transition to value-based reimbursement can severely disrupt processes and strain cash flow. Accountable Care Organizations and other clinically integrated networks may fail to deliver if the organization is unable to build a strong infrastructure, develop and engage and integrate a network of physicians along with high-quality, low-cost facilities, or make the necessary clinical and operational changes.
McKesson Business Performance Services (McKesson) is in a unique position to help healthcare leaders determine their response to value-based care. For the past 30 years, we have worked extensively with hospitals, health systems and medical groups nationwide to build and successfully manage clinically integrated networks. We have helped physicians enhance their revenue cycle management, improve practice operations and optimize clinical care.
Our experience includes working with both government and commercial insurance programs to negotiate contracts and manage a range of value-based payment arrangements. These include employer-sponsored plans, commercial plans, Medicare Advantage, Managed Medicaid, and Medicare Shared Savings Programs.