Data’s Role in Full-Risk Success

Shared savings programs do not prepare independent physician associations (IPAs), clinically integrated networks (CINs), and other providers to take on full population health management and corresponding actuarial risk. One important window into understanding how to move forward with full risk is Medicare Direct Contracting, the predecessor to the Centers for Medicare & Medicaid Services’ new ACO REACH program. Like ACO REACH participants, MDC’s Direct Contracting Entities (DCEs) agreed to shared savings and losses of 50% or 100%.

In particular, MDC provides universal lessons about using data to inform, improve, and embrace population health practices, cost management and partnerships. Our recent Group Practice Journal article, Magic Numbers: Early Lessons from Medicare Direct Contracting, offers a wealth of specifics and examples from Heritage Provider Network, which has DCEs in Arizona taking on professional risk (50%) and in California accepting global risk (100%), on:

  1. Converting Data to Actionable Information
  2. Setting and Managing Clear Performance Targets
  3. Cultivating High-Performers
  4. Improving Individual Provider Performance
  5. Adding Value
  6. Engaging Patient Involvement

Read the full article, which has a small fee for non-AMGA members.

For more information about moving to full risk, please contact us at info@copehealthsolutions.com

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