Healthcare finance leaders can expect to see significant use of value-based approaches to healthcare delivery and payment. In addition to approaches advanced by the Centers for Medicare & Medicaid Services (CMS), commercial health plans are initiating value- and risk-based approaches to varying degrees and depth in diverse markets. A non-negotiable element of this new value equation for insurers and providers is the need for an unremitting focus on improving quality, access, and efficiency.

6 Key Practices for Effective Managed Care Contracts
There are six practices that provider organizations should use in their assessment of any contract, whether risk-based or fee-for-service with pay-for-performance components.

  1. Ability of the organization to meet contract requirements
  2. Terms proposed by the health plan
  3. Coding requirements
  4. Necessary data
  5. Standard-of-care metrics
  6. Contract flexibility