The transformation to value-based programs involves many facets of the provider organization, from your revenue and physician compensation models to your clinical and operational workflows, documentation, analytics, and reporting. With such a widespread impact, Baker Tilly recommends establishing a value-based transformation steering committee with representation from all impacted stakeholder groups -- finance, administration, physicians, nursing, care coordination, case management, information technology etc. -- to inform, guide, and champion the change throughout the entire organization.
The steering committee serves as the overall transformation management committee, setting goals and objectives of the transformation while delegating day-to-day activities to project-based operational committees that design and implement specific initiatives to meet the within the overall transformation program.
Baker Tilly can help your organization establish an effective steering committee and provide a thorough transformation roadmap based on the organization’s specific goals. We conduct a comprehensive readiness assessment of all aspects of your organization that identifies areas of foundational strength while clearly describing where the organization needs improvement to maximize its success in value-based programs.
Baker Tilly’s approach to defining your strategy uses a detailed assessment tool that evaluates your organization’s preparedness against our comprehensive value-based transformation roadmap. The assessment provides insight into the readiness of your core business model components and enabling capabilities, and targets recommendations based on what types of value-based programs your organization intends to support.
Value-based programs fall along a continuum of risk from payment for volume to payment for value, with clinical and financial integration and resources needed for success increasing along with the risk and rewards for each payment model. Foundational value-based programs include pay for performance and alternative payment models that provide incentive for better patient outcomes and upside payment potential. Your organization should consider the following when moving from foundational fee for service contracts to these new models.
Advanced value-based programs tie outcomes and performance directly to payment – with your organization assuming potential downside risk while offering higher upside potential if the organization is effectively managing outcomes. These models include programs such as bundled payments, episodes of care, and ultimately full capitation models. Your organization should consider the following when moving to advanced value-based models:
Baker Tilly’s value-based readiness assessment provides a comprehensive analysis and program roadmap for your organization to implement a transformation to value-based contracting. Our approach recommends specific actions based on your preferred value-based goals (from upside only options to full capitation).