Value-Based Care Organization Maturity Assessment

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Value-Based Care Organization Maturity Assessment

Welcome to the COPE Health Solutions Value Based Care (VBC) Maturity Diagnostic Questionnaire. This tool is designed to help you assess your organization’s current state in value-based care and identify areas for improvement. Please select the option that best describes your organization’s current practices. Your responses will be compared against other respondents to rate you on a level of maturity and provide valuable insights and recommendations for advancing your value-based care capabilities.

PROD: Boris Value Based Care Organization Maturity Assessment v1.1 (ID #51806)

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- Step 1 of 2

Name *

First

Last

Email *

Organization *

Baseline Assessment

1. Experience with Value-Based Care *

We have not yet participated in value-based care programs and rely primarily on fee-for-service models.
We have begun engaging in value-based care through pilot programs and basic contracts, gaining some initial experience.
Our organization has extensive experience across various value-based care models, including shared savings, bundled payments, and advanced alternative payment models, with demonstrated improvements in quality and cost outcomes.

Governance and Leadership

2. Program Structure *

We lack a formal value-based care program, with ad-hoc efforts and no cohesive strategy or structure.
We have established a value-based care framework with dedicated teams and some integration across departments, but processes and coordination are still evolving.
Our value-based care program is fully integrated, featuring a structured governance model, cross-departmental collaboration, and clearly defined roles and responsibilities.

3. Leadership Experience *

Our leadership team has limited experience in value-based care, with most leaders new to these concepts.
Several members of our leadership team have undergone training and have moderate experience implementing value-based care initiatives, though they are still developing their expertise.
Our leadership team has extensive experience, having successfully led multiple value-based care programs, and is proficient in aligning organizational strategy with value-based care goals.

Network Composition

4. Network Composition *

Our network is heavily specialist-based, with limited primary care involvement and inadequate coordination among providers.
We have a balanced network with a solid foundation in primary care, although specialist engagement and integration into coordinated care models are areas for growth.
Our network is well-balanced, featuring a strong primary care base, engaged specialists, and comprehensive coordination that supports integrated care delivery and population health management.

Data Utilization and Analytics

5. Data Utilization *

Data is minimally used, often retrospectively, with limited impact on decision-making or risk adjustment strategies.
Data is collected and used in decision-making, but our systems are primarily descriptive, focusing on basic reporting rather than predictive analytics.
Our data systems are robust, employing advanced analytics for real-time decision-making, predictive modeling, and comprehensive risk adjustment, fully integrated into clinical and operational workflows.

6. Data Analytics Capabilities *

Our data analytics capabilities are basic, limited to simple metrics and retrospective analysis, lacking the sophistication needed for proactive care management.
We have a growing analytics capability that supports operational and financial decisions, including some predictive analytics, but it's not yet fully leveraged across the organization.
Our organization uses advanced data analytics, including machine learning and artificial intelligence, to drive strategic decisions, optimize care delivery, and enhance patient outcomes.

Operational Readiness and Compensation Models

7. Operational Readiness *

We lack clear implementation plans and the necessary resources, resulting in fragmented efforts and limited progress in value-based care.
We have foundational plans and some dedicated resources, but our strategies need refinement to ensure full readiness and successful implementation.
We have detailed implementation plans, well-resourced teams, and established processes that support efficient operations and early financial and quality outcomes in value-based care programs.

8. Compensation Models *

Our compensation models are predominantly volume-based, with minimal alignment to value-based care incentives.
We have started integrating value-based components into our compensation models, including some incentives for quality and efficiency, but there's still a significant reliance on traditional payment structures.
Our compensation models are fully aligned with value-based care principles, incorporating comprehensive incentives for quality improvement, cost efficiency, and patient satisfaction, supporting overall organizational goals.

Population Health Management

9. Population Health Capabilities *

We do not have a dedicated population health management team or capabilities, and there is minimal focus on managing population health outcomes.
We have a population health team and basic care management capabilities, including the use of care managers and some partnerships with third-party providers.
Our organization has robust population health management capabilities, including dedicated care managers, social workers, and comprehensive partnerships with third-party providers, fully integrated to manage both clinical and social determinants of health (SDOH).

Risk Adjustment Capabilities

10. Risk Adjustment *

We are limited in our ability to generate or receive suspect conditions and struggle to improve risk scores for our attributed populations.
We generate or receive suspect conditions but our capture and recapture rate is inconsistent and there is significant variance in provider performance on risk adjustment.
We routinely improve the overall risk score of our attributed populations and our capture and recapture rates are consistently high.

Comments or questions

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