KLAS Research Assesses Providers’ Value-Based Care Focus
"In order to survive in this new world of value-based care, providers need firms who can help them feel confident."
By - Healthcare providers must balance needs versus capabilities in the midst of stark competition, according to a newly released KLAS performance report. KLAS’s research assesses the overall effect of both value-based care consulting and managed care firms. It additionally evaluates how effectively healthcare providers can utilize these entities in regard to a successful transition.
Researchers who interviewed over 100 c-level executives pinpointed 33 key functions healthcare providers “must do differently” to execute a solid value-based care transition. All of these 33 functions can be categorized under organizational alignment, care management, and reimbursement management.
"A provider’s first step in choosing the right firm is to weigh their needs versus a firm's capabilities," said Warren Whitford, report author and Research Director. Each healthcare provider functions independently, he stated, as the current market environment is transitory.
"In order to survive in this new world of value-based care, providers need firms who can help them feel confident in their progress towards Triple Aim objectives, meaning can they impact patient access and satisfaction levels, help improve patient outcomes and reduce healthcare costs," Whitford asserted.
Key highlights of findings:
Healthcare providers rated Advisory Board, Conifer, and Evolent strongly. Providers said they were able to successfully handle challenges with evolving alternative payment models and better manage upcoming risk because of them. Premier and Advisory Board also earned top scores. Valence and Lumeris received top ratings within the value-based care managed services realm.
“After identifying potential firms to support their VBC transformation, providers need to feel confident in their progress toward their Triple Aim objectives. 100% of Advisory Board clients report a high impact across these objectives, citing a proven reputation for physician engagement and building CINs,” wrote Whitford in regard to client-reported impact.
“Lumeris helps providers reimagine patient care by building a complete patient profile. Valence Health empowers clients to operationalize clinical integration and provider-sponsored health plans. Premier’s collaboratives model connects providers to a community through which they can facilitate and build VBC programs.”
“Advisory Board engenders universal client confidence by supporting governance and infrastructure development. ... All of Conifer’s reporting clients feel empowered from having been taught to use data to strategically plan for risk-bearing contracts. Evolent’s ability to help providers understand the market leads to high confidence in taking risk.”
“Premier succeeds in delivering detailed governance-structure planning and leadership development; however, insufficient resources is a noted concern. Advisory Board performs well by promoting physician leadership to create CINs that better position clients for managing population health, although a high price tag can result in a diminished sense of value for clients.”
“PwC’s lower performance in an array of strategy work reflects some providers’ concerns that PwC’s boiler-plate approach can cause a disconnect between PwC’s performance and providers’ goals.”
“Although some firms claim to be a 'one-stop shop,' providers who are evaluating options for ongoing support find each firm demonstrates areas of specialty. Lumeris improves providers’ understanding of patients, although a focus on Blue Cross Medicare Advantage populations constrains payer relationships.”
“Valence Health demonstrates deep knowledge through their TPA background and strong analytics capabilities while exhibiting limitations with clinical data aggregation. Through strong partnerships, Evolent clients experience enhanced care coordination and reimbursement management services but also note issues with immature technology."
"Although Conifer excels at identifying and engaging patient populations, their low client satisfaction reflects stretched resources that in some engagements have resulted in slower than expected responses to client needs.”
