Financial Sustainability Solutions

Strategies that reduce costs are critical to the sustainability of our healthcare system. No one knows this better than IHC. However, reducing cost is only part of the equation. Healthcare providers are faced with not only treating their patients, but also managing the population of those in their care. This fundamentally changes the provider reimbursement model from volume to value-based care. We help clients thrive in a value-based environment by addressing the complexity of risk in healthcare.

Value-based Payment Delivery System and Payment Model Redesign

Accountable healthcare requires delivery and payment systems that focus on quality, not volume. Developing these systems is one of the biggest challenges to transforming healthcare. It requires better integration and coordination—not only between healthcare providers, but also with patients receiving the care. Designing payment models that focus on value instead of volume is one of the most important—and most complex—aspects of healthcare transformation. 

IHC brings years of experience helping providers design and implement value-based payment models that incentivize improved quality and outcomes. From care coordination to capitation, we help providers of all sizes maximize opportunities and chart a path to success.

To help make this happen, we have a team of clinical, financial, and administrative experts dedicated to building new delivery and payment models. They’re already working with providers to build more effective, efficient systems.

 How We Can Help
  • Implement innovations and evidence-based approaches to providing value-based healthcare
  • Strategies to transition providers away from volume-based reimbursement and toward payment based on quality and outcomes
  • Integrate primary care and behavioral health services with financing and programmatic strategies
  • Coordinate physical and behavioral healthcare with housing, employment, and other vital support systems
  • Implement Patient-Centered Medical Homes (PCMH) and Health Homes that use team-based care
  • Coordinate primary care with specialty, inpatient, behavioral health, and long-term services and supports
  • Design and implement effective team-based care, including training, mentoring, and coaching of new workforce roles
  • Identify the value-based model most suited for clients
  • Design care structures integrate clinical and financial components
  • Identify and implement new ways to integrate services within health centers and across care setting

Risk Management

As providers transition from volume to value-based purchasing (VBP) arrangements, understanding risk is critical. Risk management helps healthcare organizations protect both their patients and their organization. It requires evaluating clinical and administrative systems and processes to monitor, detect, mitigate, and prevent potential risks.  

Integrating risk management concepts into your organization can be helpful when considering risk-bearing reimbursement models such as bundled payments and CMS’ pay for performance programs. IHC and its affiliates can help you shift from a reactive to a proactive risk management structure. 

We have formed partnerships with external organizations to assist with assessing and analyzing risk management for healthcare organizations, many of which are integrating value-based payment model concepts that incentivize improved quality and patient outcomes.

 How We Can Help
  • Focused education including surveys targeting risk management readiness developed by IHC and external affiliates in conjunction with QIAs
  • Educational sessions with the opportunity for engagement and dialog
  • Risk curriculums for practices for assessing readiness for VBP arrangements
  • Provide high-level overviews of topics related to risk management in healthcare
  • Assist in achieving practice transformation
  • Help practices prepare for success in APMs
  • Assess and analyze current levels of readiness and measure progress