As financial and market pressures continue to push the industry towards value-based payments, having the right payment arrangements that appropriately transfer risk across the network becomes not only crucial, but a tenet to your long-term success in a risk bearing environment.
Understanding your high- cost drivers, stratifying them by service categories and accurately identifying the appropriate cost-containment strategies is difficult at best. Add the complexities of modeling the right risk stratification for your network, and the challenge can seem insurmountable.
COPE Health Solutions uses available data and industry benchmarks to develop our analyses to assess risk-bearing scenarios for our clients. Our models take a bottom-up approach to evaluate our clients’ medical costs, member utilization patterns, potential saving opportunities, as well as critical success factors that help us develop tailored strategies to help our clients thrive in a risk-bearing environment.
Using detailed financial pro-formas with assumptions and input that allow for assumption changes over time, our team provides recommendations for building and implementing risk-bearing payment arrangements, while also highlighting opportunities to enhance your comprehensive risk-bearing strategy, contracting and performance-based contracts.