Jennifer Carney, vice president, finance and analytics, for Beth Israel Lahey Health Performance Network (BILHPN), describes shared-risk contracts as having three basic components that executives should understand.
Infrastructure
“Given the significant resources required to succeed on the value-based contracts, providers should negotiate with the payers and transition some of those infrastructure payments over to the health system or the ACO to be able to manage these contracts.”
Efficiency
“Providers need to manage to a set benchmark, often based on historical performance, with the goal of surpassing the benchmark at the end of the day. So they need to understand their population and their risk, particularly in contracts that carve out different services.”
Quality
“It’s hard to know how to improve performance quality enough for success under risk contracts. That’s why we tailor quality reporting to each physician pod to identify their specific opportunities, rather than have one performance-metric blanket across the network.”
