Managed Care

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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.

Connect with Our Consulting Team

Connect with Our Consulting Team

Connect with Our Consulting Team
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
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Providing Deep Industry Expertise

Learn more how Kaufman Hall can help with your managed care strategy.

 

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Value-Based Care

Taking on a greater role in value-based care and positioning organizations for a more secure financial future

Well-executed, a value-based care strategy can help to solidify patient capture and volume, while also broadening revenue streams and insulating health systems from some of the impacts of reductions in overall hospital volume. Kaufman Hall collaborates with organizations to evaluate the market and devise strategically and financially viable paths to value-based care.

Kaufman Hall’s full suite of value-based care services meets healthcare organizations where they are and supports them on their journey toward value:

  • Market assessment/sensing

  • Strategy development

  • Performance assessment and optimization

  • Transformation planning and execution support

Our Experts
Webster Macomber headshot
Webster Macomber is a Senior Vice President in Kaufman Hall’s firm’s Strategy and Business Transformation practice, using his deep expertise in healthcare analytics, payer-provider partnerships, and population health to advise healthcare leaders in developing effective, data-driven strategies.