The Risk Plunge

Many provider organization executives are “undecided” about the wisdom of pursuing performance-based or value-based reimbursement (VBR) with downside financial risk. I’ve always been a fan—assuming the rate setting is sound and the contract is well written.

Why? Because it is the best reimbursement model for success with whole person care. It is an opportunity to share in the savings from good consumer health management. And it puts the “selected” provider organization in “first position” for controlling referrals and clinical practices in the service delivery system.

For specialty provider organizations, there are challenges to VBR contracts. One . . .