Transitioning to Alternative Payment Models: A Guide to Next-Generation Managed Care Contracting
Book
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Description
This book’s goal is to offer medical practice leadership teams practical guidance on navigating the shift from volume-based to value-based managed care contractual relationships. Medical practices – both independent and affiliated – that understand how their organization can and should position themselves for the future will have a significant advantage over the competition.
Honestly identifying where you are and defining where you want to be begins with developing a clear understanding of national and local market dynamics, identifying potential arrangements within your local market and applying those factors to your organization’s goals. This exercise can ultimately inform your value proposition, which becomes the cornerstone of your managed care contracting strategy.
The book will cover in detail the most common alternative payment models and what your practice should do to prepare for this transition.
Models detailed include:
- Pay for performance
- Bundled payments
- Shared savings
- Capitation
Table of Contents
Chapter 1 Introduction
Chapter 2 Triple Aim
Chapter 3 Narrow Networks
Chapter 4 Patient Liability
Chapter 5 Transparency
Chapter 6 Quality Metrics
Chapter 7 Connecting the Dots
Chapter 8 Fee-for-Service
Chapter 9 Pay for Performance
Chapter 10 Bundled Payments
Chapter 11 Shared Savings
Chapter 12 Capitation
Chapter 13 Setting up to Succeed
Chapter 14 Conclusion
Index
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