Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.



Prepare for risk-based payment with these two initiatives


Prioritizing population health initiatives is difficult in today’s mixed incentives environment. But any organization with risk-based payment contracts can’t afford to stand still on their population health strategy. Existing contracts hang in the balance. Here are two initiatives you won’t regret because they promise clear immediate and downstream payoff.

As we’ve discussed, provider organizations will continue to have a sizeable fee-for-service business for the foreseeable future. But to adopt more risk-based payment, providers must first prove to payers that they’re ready for more financial risk. This means providers must make investments in value-based care before their finances justify them.

To navigate this tension, we always recommend starting with ‘no-regrets’ initiatives: those with a compelling business case under both volume- and value-based payment environments. In the near term, they support providers in delivering high-quality, convenient care to earn and retain patient loyalty. Thinking longer term, these same investments can help providers identify their highest-risk patients and target dedicated services to the patients who most need them.

These aren’t new initiatives. In fact, they likely already live somewhere on your strategic plan. But risk changes the strategic calculus for each.


Two 'no-regrets' initiatives

Below, we’ve detailed the two most important ‘no-regrets’ initiatives to prepare for risk—and maximize mixed incentives in the meantime.

  • 1. Re-envision patient access beyond office visits.
  • 2. Scale team-based care according to financial risk.

Parting thoughts

Don’t let the persistence of fee-for-service payment prevent you from setting a clearheaded and forward-looking population health strategy. Both initiatives outlined here have clear strategic importance in this period of transition. Establishing a patient-oriented access infrastructure as well as promoting an efficient and scalable care team promise utility in today’s fee-for-service landscape as well as tomorrow’s value-based environment.

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