Payment Transformation Solution Framework
Baker Tilly’s Payment Transformation solution framework consists of four unique phases, which can be leveraged individually, in any combination, or all together based on your organization’s level of VBC program maturity:
Starting with current state feasibility assessments, our team of experts work alongside your team to design and enable end-to-end future state VBC program transformations, complete with program monitoring structures necessary to scale program success.
VBC program initiation requires defining program objectives and an assessment if the defined objectives are feasible for your organization and all partnering organizations. Determining objective feasibility often requires assessments of proposed financial and care delivery models along with your organization’s current state operational and technical capabilities, external stakeholders, and marketplace factors. Our team of experts can work with your organization to help define objectives and identify gaps necessary for closure to pave the way for success of new VBC programs.
VBC program design must focus on the critical success factors necessary to support a sustainable health plan and provider relationship including transparency, aligned financial incentives, financial and strategic sustainability, and commitment to quality and member/patient satisfaction. Once the critical success factors are established and agreed upon by both parties, then the organizations should focus on the detailed business rules and capabilities required to operationalize the program. From a health plan perspective, it is critical that program capabilities are designed to meet the specific program requirements with the flexibility to expand to future programs. Our experts can work with your organization and partnering provider organizations to design a new program using our VBC program definition methodology.
VBC programs require new operational capabilities consisting of new systems and processes as well as extensions to existing foundational fee-for-service capabilities. Enabling the new collaboration among divisions, people, provider relationship models, and new technological and operational capabilities is vital for a program's success. Our experts can help enable the people, processes, and technology required to build new VBC programs or expand existing ones.
Post launch, VBC programs require continuous monitoring and optimization efforts to ensure strategic objectives are met and performance does not atrophy over time. Our team of experts can work with your organization to ensure you have the necessary tools to track success and optimize performance of your VBC programs.