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Redefining the organization's value proposition to address evolving purchaser and patient needs and expectations. Shifting from a traditional fee-for-service model to value-based care, where the focus is on delivering high-quality, cost-effective care and improving patient outcomes.
Kaufman Hall helps healthcare organizations navigate payer relationships, optimize resource utilization, improve patient outcomes, and achieve financial sustainability in a managed care environment.
How We Help
Virtuous Cycle of Value Creation and Capture
Optimize
- Renegotiating rates that are aligned with market trends
- Enhancing clinical offerings to meet evolving consumer preferences and keeping patient services within the system as appropriate
- Increasing near-term value-based contract performance through clinical documentation accuracy and quality improvement
- Optimizing key functions and comprehensive maintenance of CDM
Grow
- Understanding unmet market demand
- Increasing patient loyalties through network strategies
- Expanding inorganically through strategic M&A activities
- Creating and capturing value through provider partnerships built on value-based care
Disrupt
- Rearchitecting the payer mix through strategic reset of select payer relationships
- Developing new and/or alternative and joint-investment models with payers
- Disintermediating payers and partnering directly with key purchasers
Our Experts

Joyjit Saha Choudhury is a Managing Director with Kaufman Hall in the firm’s Strategy and Business Transformation practice.
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Sarah Wiley is a Managing Director with Kaufman Hall in the firm’s Strategy and Business Transformation practice.
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John Poziemski is a Managing Director, Consulting Innovation Leader at Kaufman Hall, focused on Payor-Provider Strategy.
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Webster Macomber is a Senior Vice President in Kaufman Hall’s firm’s Strategy and Business Transformation practice.

Scott Christensen is a Managing Director at Kaufman Hall and a member of the firm’s Strategy and Business Transformation practice.
Managed Care Featured Insights


Blog
Navigating Health Systems Through a Decade of Change
A conversation with Rich Liekweg, CEO of BJC Health System in Missouri, and Nick Barto, president of BJC Health System


Article
Embracing the Next Phase of Inorganic Payer Growth


Research Report
Winter 2025 Kaufman Hall Report: Highlights from the 2024 Healthcare Leadership Conference


Thoughts from Ken Kaufman