Partnerships in healthcare are fundamental to the successful implementation of value-based care models that can reduce costs, address health inequities, and optimize patient outcomes. Effective collaboration considers the financial, operational, and strategic perspectives across stakeholders.

• Value-based care is a buzzword. Here's what it means.
  
• While providers and plans have historically had a relationship that’s mostly contractual and negotiation heavy, successful value-based partnerships require a new degree of strategic rigor and collaboration.
• The most successful partnerships effectively advance shared goals, use quality and operational data to make informed decisions, and make both sides more loyal (and ideally, indispensable) to the other.

Medicare Advantage (MA) is the leader of risk-based payment, far outpacing other lines of business. That said, MA is not yet the value-based care success story the industry hoped for. As enrollment increases, there will be increasing pressure to ensure better health outcomes at lower costs.

• View the forces of transformation to stay informed and competitive.
• As more seniors and health plans enter the Medicare Advantage market, the program is experiencing heightened scrutiny. Play our game of true and false to see whether MA is actually advancing value-based care.
• To achieve long-term success in MA, healthcare industry executives need to refocus their strategy from growth-at-all-costs to one more centered on value.

The future of commercial risk will influence the wide-scale adoption of VBC.

• There are two paths forward for commercial risk: Path 1. Follow in the steps of the public sector; Path 2. Chart its own course.
• Employers have the most bearing on which path the industry will follow, but not every employer is compatible with a VBC model.
• Either way, commercial risk will decide the fate of value-based care.

Value-based care relies on accurate and organized data to measure quality of care, ultimately influencing risk.

• While getting actionable, timely data is difficult, the ability to segment patients by level of risk is a fundamental capability for any organization to be successful under risk.
•  If there is a place where an executive should over invest their resources, this is it.

Success under value-based payment requires the segmentation of patients to provide the appropriate levels of service based on risk. By evolving care models, employers are better positioned to fill gaps in care management and:

•  Profitably push services to virtual channels
• Respond to the rising behavioral health needs of a community
• Advance organizational efforts that address health inequities