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
Scott Christensen headshot
Scott Christensen
Managing Director
Key areas of expertise: Oncology service line planning, nephrology and dialysis services; 16+ years in healthcare industry advising health systems, payers, and specialty healthcare services companies on growth, strategic partnership options, service line planning, and enterprise strategy.
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