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A Path to Risk: Critical Elements of a Structured Approach
Mark E Schario1,2, Peter J Pronovost3,4, Patrick Runnels5,6
1UH Quality Care Network & UH Accountable Care Organization, University Hospitals Health System, Cleveland, Ohio, USA.
Population Health Management
|February 7, 2024
Summary
Value-based care requires providers to manage both quality and cost. This framework outlines key structural elements for organizations to successfully navigate downside risk arrangements in healthcare.
Area of Science:
- Healthcare Management
- Health Economics
- Value-Based Care Models
Background:
- Value-based care (VBC) arrangements are central to accountable care.
- Most current contracts involve only upside risk, rewarding providers for good performance.
- Payers are shifting towards downside risk, recalling challenges from past global capitation models.
Purpose of the Study:
- To present a framework for succeeding in value-based arrangements.
- To identify essential structural elements for provider organizations assuming downside risk.
- To offer a practical model for navigating VBC contracts.
Main Methods:
- Focus on a framework developed at University Hospitals Accountable Care Organization.
- Applied approach to identify critical structural components.
- Analysis of essential elements for managing financial and quality outcomes.
Main Results:
- Identified key elements for success in VBC: quality performance and reporting, risk adjustment, utilization management, care management, network integrity, technology, and contracting.
- Demonstrated the applicability of these elements even without downside risk.
- Provided a strategic roadmap for value-based care adoption.
Conclusions:
- Successful assumption of downside risk in VBC requires robust structural elements.
- The presented framework offers a practical guide for provider organizations.
- Strategic planning and implementation of these components are crucial for VBC success.
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