By understanding the top 5 most common pitfalls in value-based contracting, providers and payers can effectively navigate the complexities of value-based contracting (VBC). In this blog by Senior Solutions Advisor, Ernie Valente, he’ll go over the top 5 pitfalls including risk adjustment, accidental and cost-outlier cases, and more.

Diving into a value-based contract (VBC) isn’t easy, but breaking it into key milestones can make it easier. In this blog by CEO, Co-founder, and actuary, Frank Cheung, we’ll walk through 5 milestones you should meet before entering into a VBC.

In the value-based care (VBC) space, actuaries have their work cut out. They juggle a lot, from handling tons of requests to finding the right balance between speed and detail. In this blog by Accorded Co-Founder and CEO Frank Cheung, we explore the 3 biggest challenges for actuaries in VBC and how Acumen, the actuarial data transformation platform, makes their job easier and more efficient.

The US healthcare landscape is changing. Traditional fee-for-service (FFS) payment models have proven to be financially unsustainable and ineffective at addressing patient needs, a trend that has only been exacerbated by COVID-19 and rapid inflation. The pressure from regulators, patients, and market disruptors to move away from FFS is pushing the market to reconsider how contracts should be structured to best align payer and provider incentives for improving quality of care, enhancing patient experience, and reducing cost of care.

Motivation

Employers are rethinking approaches to improving the quality of care provided to their people while also reducing the cost of care per employee. The Willis Towers Watson 2020 Health Care Delivery Survey indicated that 73% of employers intend to adopt alternative care delivery models by 2023.¹

Value-based care (VBC) is framed as the path to a more financially sustainable, equitable, and efficient healthcare system, where providers are incentivized to focus on the quality of care they deliver. This concept continues to gain traction across the industry as the most viable solution to the nation’s healthcare woes. The Centers for Medicare and Medicaid Services (CMS) - historically, a trendsetter for US healthcare - has doubled down on the concept of VBC. CMS has committed to shifting all Medicare beneficiaries to a care relationship with accountability for quality and total cost of care by 2030.²

At the recent DHNY Summit, our CEO, Frank Cheung, FSA, MAAA, moderated a panel that highlighted key considerations for providers when navigating from fee-for-service to value-based care models.