Managed Care

Meeting of doctors and hospital administration

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.

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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