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(1)

PREPARING FOR VALUE BASED PAYMENT:

Financial Considerations

Presented by: Peter R. Epp, CPA

(2)

O v e r v i e w

Payment Reform Initiatives

Medicare

Medicaid

Overview of Value-Based Purchasing – “Patient-Centeredness”

Managing the Cost per Patient – In-House Services

Global Payments/Budgets

Transitioning to Tomorrow

(3)

M e d i c a r e ’ s P a y m e n t R e f o r m

G o a l s

 On January 26, 2015, DHHS announced its goals and timeline for shifting Medicare reimbursement from volume to value

 Goal for shifting Medicare fee-for-service reimbursement to alternative payment models (e.g. ACOs and/or bundled payment models)

– 30% by 2016

– 50% by 2018

 Additional goal of tying traditional Medicare payments (fee-for-service) to quality and value (e.g. Hospital Value Based Purchasing and Hospital Readmissions Reduction programs)

– 85% by 2016

– 90% by 2018

 DHHS will also intensify its work with states and private payers to support adoption of alternative payment models, attempting to exceed the

(4)

M e d i c a r e ’ s P a y m e n t R e f o r m

G o a l s

Fee-for-service linked to quality = Categories 2 though 4

Alternative Payment Models = Categories 3 and 4

(5)

N e w Y o r k S t a t e - D S R I P a n d V a l u e

B a s e d P a y m e n t R o a d m a p

• DSRIP is a 5-year incentive payment program to be paid “in addition to”

the Medicaid program to assist providers with transforming to a high-performing healthcare delivery system

• During the DSRIP project period (April 1, 2015 – March 31, 2020), the

Medicaid program will be transitioning to value-based payment

• When we wake-up on April 1, 2020, the Medicaid program will be

reformed to include integrated Performing Provider Systems with:

‒ 100% Medicaid managed care AND

(6)

V B P A r r a n g e m e n t s – “ T h e 3

-L e g g e d S t o o l ”

 VBP arrangements contain a hybrid of several different payment models to incentivize and tie together desired behaviors

 The key components of VBP arrangements include:

− Base Compensation Models

• Fee-for-service

• Partial capitation

• Care management PMPM

− Quality Incentive Payments

− Global Payments/Budgets • Surplus-sharing/Risk-sharing • Global capitation 6 VBP Arrangements Qual ity Inc ent iv e Pay m ent s

(7)

E l e m e n t s o f a V a l u e - B a s e d

P a y m e n t M o d e l

An ACO manages the total cost of care (global budget) for patients

attributed to the ACO

Beneficiaries are assigned to an ACO based on a specified attribution

algorithm

MCO pays providers within the ACO for services provided and

monitors the global budget.

MCOs pay providers for specific services (Base Compensation)

– Fee-for-service versus partial capitation

– PMPM case management fee

Providers may also be eligible for quality incentive payments

Surplus-sharing/Risk-sharing arrangements:

– Surpluses/losses shared amongst providers based on an algorithm established by the governing body

Amount of surpluses/losses shared are often impacted by performance against specified performance metrics!

(8)

S u m m a r y – V B P A r r a n g e m e n t s

 Success in VBP arrangements requires:

– Knowledge of the payment mechanisms that drive each component of these arrangements

– Development of new workflows and reporting

 The key components of VBP arrangements include:

− Base Compensation Models

• Fee-for-service

• Partial capitation

• Care management PMPM

− Quality Incentive Payments

− Global Payments/Budgets

• Surplus-sharing/Risk-sharing

• Global capitation

(9)

B a s e C o m p e n s a t i o n P a y m e n t

M o d e l s ( I n - H o u s e S e r v i c e s )

As VBP arrangements evolve, payments to FQHCs will change away

from the traditional “per visit” model

Payment will be moving towards quality outcomes and

patient-centeredness

As such, the financial model and mindset must change!

– Budgeting

– Financial reporting

– Operations/Clinical

Revenue/Cost

(10)

M a n a g i n g t h e C o s t P e r P a t i e n t

( I n - H o u s e S e r v i c e s )

Financial Performance per Patient

10

` Patient A Patient B

Revenue Per Member Per Year:

Fee-for-service

Capitation

Care Management Fee Quality Incentive Payments

$ 300 $ 300

Cost Per Member Per Year (PMPY)

$ 250 $ 375

Financial Success $ 50 $ (75)

(11)

To d a y - I m p r o v i n g E f f i c i e n c i e s

A n d R e d u c i n g T h e C o s t P e r V i s i t

All-inclusive cost per visit analysis

The following variables impact the all-inclusive cost per visit and

must be managed to improve financial performance:

• Salary levels and staffing mix

• Support staff ratios (direct care versus patient support)

• Amount of enabling and ancillary services

• Administrative/overhead infrastructure

• Provider productivity/clinician capacity

Center’s will continue to monitor/manage these cost/operating metrics

as they move to Value Based Payment!

$ 1,542,100

$ 154.21 per visit 10,000 visits

(12)

To d a y – E v a l u a t i n g C o s t P e r

P a t i e n t

12

Service Description

Patient

Utilization Unit Cost

Annual Cost per Patient

Primary Care 3 visits PMPY $175 per visit $ 525 Behavioral Health Care 1 visit PMPY $100 per visit 100 Care Management (PCMH) 1 patient $75 per patient 75

Total Direct Care 700

Administration/HIT 20% of direct 140

Total Cost PMPY $ 840

Total Cost PMPM $ 70

Simple Cost PMPM Calculation – Per Visit per Patient Basis:

This example highlights the importance of understanding patient utilization of services on a high level!

The analysis would be further enhanced if utilization and cost were analyzed on a per procedure basis (use of a cost-based charge structure)!

Utilization varies by health condition of

(13)

To m o r r o w – E v a l u a t i n g C o s t

P e r P a t i e n t

Service Description

Patient Utilization

Unit Cost (per procedure RVU) Annual Cost per Patient Primary Care: Office Visits 3.00 $ 150 $ 450 Immunizations 1.00 10 10 Medical Nutrition 2.00 60 120

Behavioral Health Care:

Individual psychotherapy 1.00 100 100

Group psychotherapy 2.00 50 100

PCMH Services:

Case management 4.00 10 40

Total Direct Care 820

Administration/HIT 20% of direct 164

Total Cost PMPY $984

Total Cost PMPM $ 82

Complex Cost PMPM Calculation – Per Procedure per Patient Basis:

Cost-Based Charge Structure

(14)

E v a l u a t i n g C a r e M a n a g e m e n t

F e e A r r a n g e m e n t s

Financial success with care management PMPM payments requires

understanding care management costs PMPM

Key financial metrics

− Care manager capacity (productivity)

− Patient utilization

Productivity: Patient Utilization:

# of service units/FTE # of service units/patient/year

(e.g. 2,400/FTE) (e.g. 12/patient/year)

Panel Size = 200 patients/FTE

If the personnel cost of a care manager is $75,000 and requires

annual HIT support of $10,000, what is the cost PMPM?

− $35 PMPM ($85,000 annual cost ÷ 2,400 member months)

− What happens to the cost PMPM if patient utilization increases?

(15)

S u c c e s s i n V B P A r r a n g e m e n t s

f o r I n - H o u s e S e r v i c e s

As Centers move away from fee-for-service payment arrangements to

VBP, patient-centered care, the drivers of success expand:

− Proper coding of services provided required for appropriate risk-stratification of patients

− Managing provider productivity impacts panel size and thereby revenue

− Managing the cost per patient

• Improving cost efficiencies (per visit or per unit)

• Monitoring clinical staff capacity and panel sizes

• Managing patient utilization and health condition

– Actuarial mix of patients including cost and utilization patterns

– Unusual utilization patterns and drilling down to the patient level and identifying high utilizers of services

(16)

G l o b a l P a y m e n t / B u d g e t s – K e y

C o n s i d e r a t i o n s

Key items which impact success:

Panel formation

– Enrollees

– Attribution

Development of overall budget

– Utilization assumption based (bottom up) – “Paid Claims”

– Historic baseline or revenue based (top down) – “Medical Loss Ratio”

Protections against outliers

– Stop Loss

– Carve-Outs

(17)

P a t i e n t A t t r i b u t i o n

In a fee-for-service demo where patients retain freedom of choice,

the payer assigns beneficiaries to ACOs based on their specific

attribution algorithm

– Usually beneficiaries are assigned to an ACO if the beneficiary receives the plurality of his or her primary care services from primary care physicians within the ACO

– Attribution models will also include specific look-back periods for claims data to make attribution decisions

– Attribution models may also include a 2-step processes in which beneficiaries are first assigned to specific sub-populations, and then attributed based on specific attribution algorithms

 In a mandatory managed care environment, the beneficiary is generally attributed to their assigned Primary Care Provider

ACO participants that bill for primary care services are generally required to be exclusive to an ACO for a specific payer

(18)

B u d g e t / B e n c h m a r k S e t t i n g

Setting a “Budget Target” – Bottom Up Approach:

Service Description

Expected

Utilization Unit Cost

Cost Per Patient Per Year

Inpatient Care 1 $3,000 per discharge $ 3,000 Emergency Services 1 $500 per visit 500 Specialty Care 2 $150 per visit 300 Primary Care* 3 $125 per visit 375 Behavioral Health Care* 1 $100 per visit 100

Laboratory 8 $25 per lab test 200

Radiology 2 $100 per xray 200

Pharmacy 12 $25 per script 300

PCMH Services* 170

Administration/HIT 855

(19)

S u r p l u s / R i s k - S h a r i n g – K e y

C o n s i d e r a t i o n s

Keys to Success

Monitor the cost and utilization of services provided by other

providers:

– Analyze total cost PMPM by actuarial class

– Cost per unit (visit or procedure)

– Utilization trends

– Identify high cost patients

– Identify high utilizers of services

– Analyze high cost providers (unit cost)

– Further analyze by health condition

– Ensure quality measures are met

Health information exchange systems

Quality partners have been identified and arrangements executed

Informatics and data reporting systems to manage all services

provided to the patient

(20)

U s i n g T h i r d - P a r t y C l a i m s D a t a

Analyze the high cost and high utilizing members

Combine Claims data files

Determine the Total Cost of Care by patient and PMPM

Determine Total Cost of Care for patients with like conditions

(e.g., all diabetic patients regardless of comorbidities)

Stratify the high cost/high utilizing members and develop

plans to better manage care and reduce the Total Spend

Clinical interventions to manage utilization

Outreach efforts/patient engagement

Specialty referral practices and high cost specialists

Link to EHR/PMS, ED Use and High Risk Member Reports

(21)
(22)

U s i n g T h i r d - P a r t y C l a i m s D a t a

(23)

I s Y o u r C e n t e r P r e p a r e d f o r

V B P ?

Excerpt – “NACHC Payment Reform Readiness Assessment Tool”

QUESTION

27. The health center has identified the up-front costs of participation in the proposed payment model.

28. The health center is able to track system-level utilization and cost data for its patients.

29. The health center has analyzed how payment timing and

methodology for a proposed payment reform model relates to health center revenue cycle management needs.

30. The health center has experience and capacity to manage performance-based contracts.

31. The health center has secured appropriate legal and compliance expertise for payment reform activities.

32. The health center has developed a business case for linking reimbursement to utilization and social complexity of health center patients and health center cost structure.

33. The health center has analyzed its ability to engage in risk-based contracts.

34. The health center has an established strategy for coordination of performance-based incentives and payment reform strategies across payer types.

35. The health center has analyzed the relationship between payment reform models and health center PPS or alternate payment methodology (APM) payment for Medicaid.

36. The health center has developed internal payment incentives based on quality and patient outcomes rather than volume. 37. The health center is leveraging all the available state and local

assistance and funding to support payment reform and service delivery transformation efforts.

(24)

P r e p a r i n g F i n a n c i a l

M a n a g e m e n t S y s t e m s f o r V B P

Cost Efficiency of Current Operations

In preparation for VBP, centers need to ensure that services

currently provided in-house are provided efficiently as well as

with high quality

Efficiency is attained through the management of –

Actual cost of providing services

Clinician productivity (coupled with quality)

Historically, centers have monitored the cost per visit of

providing services; this measurement needs to move down to a

per procedure basis

Coding is also critical to improving efficiency and quality

(25)

P r e p a r i n g F i n a n c i a l

M a n a g e m e n t S y s t e m s f o r V B P

Cost Efficiency of Current Operations

What should a health center do today?

– Monitor/manage provider productivity levels

• Move from a “per visit” basis to a “per procedure” basis

• Regularly review provider productivity reports with clinical leadership

– Monitor/manage productivity/capacity levels of non-provider staff

– Improve cost efficiencies and reduce the current cost of care per unit

• Concentrate efforts on reducing the current cost of care (move from a “per visit” to a “per procedure” basis)

• Aside from productivity, identify other areas for improvement (e.g. support staff ratios, panel sizes)

– Refine and utilize your “cost-based charge structure” as a unit costing system

• Begin to capture services for non-CPT codable services (e.g. social determinants of health)

(26)

P r e p a r i n g F i n a n c i a l

M a n a g e m e n t S y s t e m s f o r V B P

Financial Analysis of Patient Centered Care

Success under VBP requires a financial system that provides

financial and operational data to understand the underlying cost

of a patient and linked to their clinical conditions

For services provided in-house –

Coding of services is imperative as costs need to be captured and

measured at the per procedure basis

Managing the utilization of services provided per patient is the

second variable in understanding the cost per patient

VBP will also require centers to take on the management of

care outside of its 4 walls

These analysis will require new capabilities and systems

(27)

P r e p a r i n g F i n a n c i a l

M a n a g e m e n t S y s t e m s f o r V B P

Financial Analysis of Patient Centered Care

What should a health center do today?

– Further enhance coding accuracy of providers

• Coding training during orientation with annual updates

• Monitor coding practices and address anomalies

• Consider hiring of HIM professionals certified coders

– Move to managing the total cost per patient for in-house services

• Manage/monitor utilization of services

• Move from a “per visit” to a “per procedure” analysis

• Consider non-CPT codable services

– Manage quality metrics that drive incentive payments

• Document/catalog metrics which drive quality incentive payments

• Design reports to manage/monitor metrics; understand data elements

• Review quality incentive payment programs and metrics with clinical

leadership on a regular basis and implement clinical interventions to improve outcomes

(28)

P r e p a r i n g F i n a n c i a l

M a n a g e m e n t S y s t e m s f o r V B P

Financial Analysis of Patient Centered Care (continued)

What should a health center do today?

– Actively engage with the management of the total cost of care of assigned patients/members

– Consider participation in shared-savings arrangements

– Demand claims data from third party payers!

• Monthly Data Reports

– Member Enrollment Roster

– Member Emergency Room Utilization and Cost

– Member Inpatient Utilization and Cost

– High Risk Identification List (Top 10% High Risk Members)

• Recent Claims Data

– Outpatient Medical Claims

– Outpatient Behavioral Health Claims

– Pharmacy Claims

– Inpatient Claims

(29)

P r e p a r i n g F i n a n c i a l

M a n a g e m e n t S y s t e m s f o r V B P

Financial Health

VBP brings with it many unknowns to the financial well-being of

health centers

Prior to participation in VBP, centers need to ensure that their

financial house is in order –

Financial condition and reserves

Operational financial performance under today’s financing

mechanisms

(30)

H e a l t h C e n t e r S u c c e s s i n V B P

A r r a n g e m e n t s

30 Managing the Visit Managing the Patient In-House

Fee-For-Service Partial Capitation Global Budgets

Overall Patient Utilization High Value Providers

Patient Utilization Quality Metrics

Panel Sizes Quality Metrics Effective Coding Cost Efficiencies Managing the Patient Total Cost

(31)

C h a n g i n g R o l e o f t h e C F O &

F i n a n c e F u n c t i o n

Additional roles/functionality of the future

Connecting with clinical leadership:

• Understand metrics/outcome measures that drive incentive payments

• Managing patient utilization both in-house as well as out-house

Better understanding of the health center’s patient base to impact

attribution

• Patient satisfaction

• Primary care and preventive services coding

(32)

C h a n g i n g R o l e o f t h e C F O &

F i n a n c e F u n c t i o n

Additional roles/functionality of the future

Emphasis on cost accounting and unit-costing

• Analyze/drive cost efficiencies

• Need to develop a new internal budget model centered around patients – in-house versus out-house

Heightened involvement with collaborations and strategic planning

• Documenting value

• Understanding funds flow

Risk management – managing risk-sharing arrangements

New required skill sets/functionality

• Care management/coordination

• Clinical informatics

• Business intelligence solutions

(33)

S u c c e s s f u l T r a n s i t i o n t o T o m o r r o w

(34)

C O N T A C T I N F O R M A T I O N

Peter R. Epp, CPA, Partner

Practice Leader – Community Health Centers

CohnReznick LLP

646.254.7411

Peter.Epp@CohnReznick.com

(35)

HMA

HealthManagement.com

Preparing for Value-based Payment:

Clinical Considerations

Art Jones, MD

(36)

AccountableCareInstitute.com

Hypothesis: Successful FQHC Transition to

Accountable Care Requires

2

1. Patient Centered Medical Homes

2. Clinical and Financial Integration (with shared governance and

decision authority) with reform minded partners

3. Data analytics and connectivity real time

4. Targeted, innovative model for the full continuum of care 5. Multi-payer outcomes based payment

6. Patient engagement/wellness programs

(37)

Clinical Focus

Improving transitions of care

Care Management of high risk patients

Behavioral and physical health integration

Reducing low value medical practices

Performance on Quality Parameters

(38)

AccountableCareInstitute.com

High Value, Consumer-facing

Practice Transformation

Team-based care with non-billable providers

Enhanced access to primary care

– Urgent care center level of access – Expanded hours

– Nurse triage

– Phone consultation

– Management over the patient portal

E-consults for specialty care

Structured care management at the PCP practice level

informed by analytics fed by multiple data sources

including real time hospital ADT alerts and impactable

social risk factors

Home and nursing facility visits

Telemedicine

(39)

Distinct Provider Types

Social Workers Other Specialists Primary Care Physicians Mental Health Clinics Community-based Orgs. Hospital

When health care is not integrated, continuous linkage to

care from the hospital to outpatient providers represents a

greater challenge

(40)

Integrated Health Systems

The New York DSRIP Model

Substance Abuse Providers Other Specialists Primary Care Physicians Mental Health Clinics Social Workers Hospital

Integrated health systems offer better linkages to care

between the hospital and

(41)

Comprehensive, Community-based, Integrated

(42)

HMA

Oregon Results for 3 Pilot FQHCs

Paid a PMPM APM within a CCO

Metrics:

(January 1st 2013 through December 31st 2013):

Tobacco Screenings hit and remained at 100%

Weight control for kids increased by 145%

Childhood immunizations increased 115%

Patients with a favorable survey response

regarding their care team averaged 96% among

the health centers (a 50% increase)

Increases seen in diabetes control, cervical

cancer screening, weight control for adults.

Depression screening unchanged

Decrease in blood pressure control

(43)

Oregon APM 1

st

Year Results

Inpatient utilization: average decrease in trend of

20.3%

Note: Year 3 Pre-APM is counter-factual projection (trend). Post-APM is actual data. Optumas , 2015.

Inpatient Utilization Per 1000 by Facility & Population

Mosaic OHSU Virginia

Pre APM Post APM Pre APM Post APM Pre APM Post APM

Year 1 631.8 - 1,284.9 - 646.0 - Year 2 666.8 - 1,365.9 - 613.2 - Year 3

(Pilot)

(44)

HMA

Oregon APM 1

st

Year Results

ED utilization: average decrease in trend of 5.6%

Note: Year 3 Pre-APM is counter-factual projection (trend). Post-APM is actual data. Optumas , 2015.

Outpatient ER Utilization Per 1000 by Facility & Population

Mosaic OHSU Virginia

Pre APM Post APM Pre APM Post APM Pre APM Post APM

Year 1 862.5 - 1,081.5 - 653.8 - Year 2 833.2 - 1,007.0 - 661.6 - Year 3 (Pilot) 825.2 792.4 881.7 837.8 633.8 580.2 10

(45)

Minnesota FQHC Urban

Healthcare Network

10 FQHCs in the Twin Cities with an attributable population of 24,000 (total MA population 50,000)

Based on historical

under-spending in primary care, and overspending in hospital/ER care

• Only IHP model consisting of independent provider groups. • Secured business partner

(Optum) to assist with infrastructure and data analytical support

Upfront investments costs borne solely by IHPs= $0 state support 10.3% ER Visits $2.6 Million in MA Savings

For Year 1, 100% of savings accrued to the state … even though FUHN fronted 100% of

costs!

(46)

HMA

Medicaid Integrated Health Partnerships

(IHP) Demonstrations

Total Cost of Care (TCOC) or

Accountable Care Organization

(ACO) approach to delivering

health care to specific set of

patients

Move away from

Fee-For-Service to provider group

assuming risk

6 organizations initially serving

100,000 Medicaid enrollees

Base Year 1 Year 2 Year 3 Baseline 2% Threshold Actual TCOC “Savings” split 50/50 between state and HCDS after meeting 2% cost threshold

Must also meet

QUALITY

BENCHMARKS

(47)

MHN ACO Providers MHN ACO Geography 9 FQHCS 3 Hospital Systems 86 Medical Homes 360 PCPs 120 Care Managers 1200 Specialists 5 Hospitals

MHN ACO & CountyCare Membership

(48)

14

Growth in Total Cost of Care

:

MHN vs. non

MHN Matched Cohort Trend

-1.9% 4.3% 1.4% 9.3% -4.0% -2.0% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0%

Trend Over Baseline Period

MHN Risk Adjusted Performance Year 2 vs. Baseline Performance Year 1 vs. Baseline In Year 2, MHN risk-adjusted PMPM growth in total cost of care is 5% lower than non-MHN

(49)

Improvements in Patient Engagement and

Care

71.4% of 80,000 members have completed Health Risk

Assessment

July 2014 – May 2015

34% reduction in bed days/1000*

13.9 % reduction in ED visits/1000*

35% reduction in readmission rates*

Reduction in global care of care results pending claims run out

* Reflects the reduction achieved by MHN PCPs as compared to non-MHN PCPs in the CountyCare

program; MHN has 48% of the ~180,000 CountyCare member population. CountyCare is a no-cost publicly funded managed care health plan in Cook County, Illinois.

(50)

16

The Building Blocks for

Delivery System Transformation

& Population Management

(51)

Challenges to Care Coordination Services

• Patients expected to

coordinate on their own

• Telephonic care

management ineffective

in engaging patients

• Lack of systematic

approach to care

management with tools

and electronic platform

• Outpatient providers

unaware of patient

admits and discharges

• Lack of timely

bidirectional

(52)

Care Management Connect: Tracking Quality Assessments & Indicators

18

TM

(53)

FINDINGS

1. MHN’s risk stratification algorithm accurately correlates with subsequent cost of care

2. Presence of risk factors even in the absence of historical high inpatient or emergency room utilization increases subsequent cost of care by approximately 29%

3. Inability to complete a screening HRA in an individual accessing subsequent health care services approximates the cost of a moderate risk member

HRA Completion Rate

MHN ACO 71% External Network 31%

(January 2015 – June 2015)

HRA Risk Profile Count

% of Members % Members with No Claims ER Visits /1000 Inpatient Admits /1000 Medical PMPM Relative Cost No HRA - no claims 4,088 22% 100% 0 0 $0 0

No HRA - with claims 8,303 44% 0% 1,070 220 $301 174%

Low 1,270 7% 29% 413 80 $173 100%

Low: 1-3 risk factors 3,306 17% 19% 591 100 $223 129%

Medium: 4-5 risk factors/high ED 878 5% 14% 945 200 $284 164%

High: >5 risk factors/ high inpatient 879 5% 11% 1,370 340 $441 255%

Total 18,274

(54)

Medical Home Network:

Driving Effective Population Health

MHN judges effective care management by its ability to lower patient risk

Medical Complexity Behavioral Health Complexity Level of Risk Social Complexity

High Risk High Risk

High Risk

Low Risk Low Risk Low Risk

Criteria

• Frequent ED Use

• Avoidable Hospitalization

• Chronic PQI

(potentially avoidable hospitalization)

• Gaps in Care

Criteria

• Hospitalization or ED

Use for SMI or SA

• High PHQ9

• Untreated SA

Criteria

• Barriers to therapeutic

compliance

(55)

Are PCMH/P4P/Shared Savings Payments Enough or

Do We Need an Alternative Payment Methodology?

1 2 5 3 4 Managed Care Organizations & Direct Payers Reimbursement Structure:

• All MCOs/Payers offer P4P with uniform parameters measured in a standardized fashion

• All MCOs/Payers offer shared savings/capitation based on standard set of services

• Contracts cover most if not all of a provider’s panel

FQHC IPA

IDS

• Aggregates data from multiple MCOs/Payers for

total actual performance

• Establishes a performance/incentive method to

pass rewards to the practice level to providers that are creating value

• Provides performance reports, transparency &

consultation to individual practices/providers

• Manages contracting process PCP

PCP PCP PCP PCP PCP PCP Behavioral Health Specialists Hospital

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