SERVICES
Operational Guidance
The work after the contract is signed, where savings are either earned or quietly lost.
The Problem
A signed value-based contract does not produce savings. Performance does. And performance depends on a set of unglamorous operational disciplines that most organizations underestimate: whether risk scores are captured accurately, whether attributed members stay attributed, whether care management reaches the patients who actually drive cost, whether quality measures are reported correctly and on time.
These are the areas where a well-designed strategy leaks money. We have run them.
What We Do
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Risk score capture: documentation accuracy, coding workflows, and annual wellness visit strategy
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Care management design: targeted at the cost drivers in your specific population rather than a generic high-risk list
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Utilization and cost management: including post-acute utilization and length-of-stay
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Member attribution and retention: understanding why members leave your panel and closing the gaps
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eCQM reporting and quality performance: from measure selection through implementation and project management
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Emergency department diversion: (see also Nonemergent Care Planning)
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Performance monitoring: with dashboards your operating committee will actually read
What You Get
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Identified gaps in your current operations, ranked by financial impact
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Redesigned workflows with named owners, not recommendations in the abstract
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Process and outcome dashboards
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Ongoing performance review against benchmark, with course corrections while there is still time to make them
Results
20%+ reduction in cost of care achieved in the Medicare Shared Savings Program.
Top 10 quality performance** among Texas ACOs.
Let's talk about your risk arrangements.
Customized service, delivering experience & expertise