Editor’s note: This article originally appeared on ECG’s website.
In our initial blog regarding the health systems of the future, we defined two key drivers for success: patient centricity and value transparency. Achieving these involves daunting transformations across multiple dimensions. So when should we be prepared to focus our efforts to support this transformation?
Though the two drivers noted above provide competitive advantages even in predominantly fee-for-service markets, they become critical in markets where the cost risk for care shifts to the provider network and even more so if the risk shifts to a single provider organization. A significant level of cost risk requires a health system to deliver care in a more efficient manner through a combination of population health management and cost reduction. To say this will be challenging for most systems is an understatement.
Although the majority of providers will face some level of cost risk through CMS-driven payment models (Medicare or Medicaid), the actual level of risk exposure in a given organization will depend upon a variety of factors. The evolution of risk-based payment models is not uniform; not all markets are evolving at the same rate, due to differing demographics, economic trajectories, competition, historical trends in employment patterns, and payer margins. Click here to continue>>
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