Value-based Care Contract Performance Consulting

Health Catalyst’s Value-based Care Contract Performance Consulting service follows a strategic, data-informed approach to evaluating value-based contracts and your organization’s actual or potential success within them. Flexible and tailored to the needs of your system, an engagement with our experts may include risk assessment, modeling and negotiation structuring, opportunity analysis, and guidance for designing data and analytics that optimally support performance management for your specific value-based care contracts.

The problem

As movement toward population health management continues to accelerate, healthcare systems increasingly realize the need to approach value-based contracting arrangements carefully. Selected and executed effectively, these payer-provider contracts can be the key to accessing new market segments, lowering costs, and improving quality. However, when they’re not carefully designed, these arrangements often prove unsustainable—and may even threaten the financial foundation of the organization.

Our approach

Drawing from our deep bench of value-based care experts, our team partners with you to assemble and interpret a holistic view of the payer market and your organization’s position within it—and to support decisions about priorities, participation in specific programs, network management, etc. Our team can also identify opportunities to improve performance in individual governmental and commercial arrangements and help you devise plans to manage risk and maximize resources. And leveraging our company’s extensive background in healthcare analytics, our team can identify clinical and financial data and metrics you need to understand covered populations and optimize contract performance.

Benefits and components

Access empowering insight into a flexible partnership. Tailored to the needs of your organization, an engagement with our value-based care consulting team may include one or more of these elements:

• Risk assessment: Weigh actual or potential contract success by reviewing payer market, competition, top-volume and high-quality areas, payment history, benchmarks, and more.
• Retrospective and prospective modeling, negotiation structuring: Forecast financial impact of value-based contracts using sensitivity analysis and a multi-year framework; set criteria for contracts and terms
• Opportunity analysis: Use data to develop improvement areas and interventions
• Support for sustainability: Develop analytics dashboards to monitor performance, manage risk, and drive clinical and financial improvement