Understand how we got here — and how to move forward.



Care management readiness audit


With increasing interest in total cost of care contracts, providers are actively pursuing care management capabilities to succeed in these arrangements. Providers are hiring care managers, training staff, and investing in data platforms to prepare for future risk-based payment models. Many of these functions are already provided by the plan and providers are at risk of duplicating efforts.

Plans have historically struggled with member engagement in their care management efforts and should strongly consider transferring care management responsibility to the provider, when appropriate. However, few providers are ready to fully assume responsibility for care management and will need health plans to provide data and other infrastructure to help them make this transition. By identifying where providers need the most assistance with care management, health plans can find innovative ways to partner with providers to effectively address population health needs.

This audit helps health plans identify the providers that are most prepared for a greater role in care management. Though every plan/provider relationship is different, this tool will help plans determine where their provider organizations fall on the care management spectrum and how the health plan can support their transition to full ownership.

Download your copy of the care management readiness audit and measure your providers' care management capabilities in areas like staff, data, care pathways, and financial incentives, and more.

Download the audit

Have a Question?


Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.