Developing Case Rates? Better Find Your ‘Single Source Of Truth’

Knowing how to develop bundled payments and case rates is an executive team skill set that will become more important as value-based reimbursement models mature. While the majority of VBR contracts remain in fee-for-service models with a bonus or penalty, the use of case rate reimbursement is on the rise, and this brings a new level of financial risk to provider organizations (see Health Plan Contracting Opportunities – More Consistency Emerging and VBR @ Scale—Changes Required).

They offered five key pieces of advice developing case rates, and then managing to those rates.

Develop a "roadmap to capitation"—In . . .