Health Systems See Returns on Risk-Based Reimbursement

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Modern Healthcare’s 2017 Hospital Systems Survey has found that more than 30 percent of respondents that derive patient revenue from “risk based contracts” recorded a surplus in 2016. While moving towards more value-based payment models takes time and requires a significant investment (and commitment to) in structural change, the outcomes can be incredibly beneficial for those that do.

Modern Healthcare highlights four large organizations that are taking on various levels of risk, which are resulting in significant changes in net patient revenue. And on top of having the internal structures in place to move more aggressively toward value-based payment models, the article also notes that partnering with local community organizations is a critical piece of the puzzle for some groups. Stephen Rosenthal, senior vice president of population health management at Montefiore Health System in New York, says “when taking on financial risk, you need to partner with community organizations who can provide healthy food, shelter and the housing needed to keep people healthy. You can't do it alone."

DCHI’s Payment Model Monitoring Committee advocates for the transition of all payers, providers and health systems to a value-based payment model by 2020. Value-based outcomes reward quality and efficiency of primary care delivery, and ultimately serve to manage/lower rising healthcare costs. This approach supports DCHI’s broader delivery system transformation (e.g. population health improvements, behavioral health access and integration) and emphasizes the role of Advanced Primary Care. For more information on how DCHI is moving hospitals and provider groups towards a value-based payment model, with a goal to have 80 percent of Delaware’s population in value-based payments by 2019, please visit us at https://www.dehealthinnovation.org/.

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