In the complicated world of value-based care, the focus primarily is – and should be – providing the best patient care while mitigating wasted Medicare spend. Out-performing your benchmarks means a greater reward for you, your network, and everyone in Medicare-related industries. But before you can begin reaping your rewards, you have to tackle the building blocks of managing your risk-sharing entity. Whether you’re an experienced accountable care organization (ACO) or an emerging direct contracting entity (DCE), building a strong network or acute and post-acute physicians, optimizing that network, and leveraging preferred provider relationships with post-acute care organizations are crucial components that need to be addressed.
At Trella Health, we know that, for you to be successful, you need actionable insights and performance patterns for the physicians in your market – but you also need a way to apply these numbers to help create a strong foundation for future ACO or DCE success. The resources below were created to help you navigate the essential components of a successful value-based care entity, regardless of where you are in the process.
Get a strong start to building a new network or optimizing your existing one – ahead of the unknown deadlines for performance year 2023 (PY 2023).
Building a strong value-based care network sets the tone for how likely it is you’ll reach your benchmark. For risk-sharing groups like ACOs and DCEs, you need to look at the clinician-level claims alignment and performance metrics to determine which groups or physicians could benefit your roster.
In our guide, “ACO & DCE Building: Key Considerations on Your Journey to Value-Based Care,” we explore insights and lessons learned from interviews with more than 50 ACO leaders. From where they’re focused to where they need to grow, you’ll get a glimpse of what it takes to be a successful risk-sharing entity.
Once your network contracts are signed, sealed, and delivered, it’s time to start analyzing performance. Optimizing means more than just analyzing, though. For example, you may need to reassess which clinicians you refer to within a physician group. Or maybe you need to work on ways to increase efficiency with your network partners. Alternatively, if your network is trending in a way that indicates you might not meet your goals, you should start looking for non-contracted solutions.
The final building block for successful ACO and DCE groups is building out a strong network of preferred post-acute care providers. While these physicians may not be on your official contracted network roster, they are high-performing clinicians who you know will impact your benchmark in a positive way. 73% of Medicare spending variance comes from post-acute care – ensuring your patients make it to the right care setting and the right physician at the right time will have a positive impact on both you and your patients.
Even though it may not feel like time to start planning your PY2023 network, the mid-year deadlines are going to show up sooner than you expect. That’s why it’s important to start diving into the important metrics you need to build or change your network.
Trella Health is the leader in market intelligence for the 65+ population, with extensive data sets including Medicare FFS, Medicare Advantage, commercial payers, ACOs, and DCEs. To learn more about how data insights and analytics for key metrics can help you control costs, improve patient outcomes, and build a stronger physician network, schedule a demo today.
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