Transition from Volume- to Value-Based Care: Adopting and Adapting to Alternative Payment Models and Value based Contracting
Foley partner Kinal Patel, co-chair of the firm’s Payor/Provider Convergence Area of Focus, is speaking at TexMed 2024 in a session titled “Transition from Volume- to Value-Based Care: Adopting and Adapting to Alternative Payment Models and Value based Contracting” on May 4.
The presentation will discuss the role of alternative payment models and value-based contracting to meet outcome-based goals. The session will provide an introduction to independent physician associations, physician hospital organizations, and clinically integrated networks (CINs) as provider network manager organizations. The presentation will include how to identify laws governing such organizations, including state licensing and registration requirements, and will conclude with an outline of the mechanics of network building and payor contracting functions, including the interplay with antitrust rules, and discuss some of the key managed care contracting terms for practices.
Upon completion of this lecture, attendees will be able to:
- Identify opportunities to transition to value-based care reimbursement models independently or through a provider network structure.
- Measure quality and other performance measures under value-based payor contracts.
- Analyze opportunities to improve those measures (e.g., staffing, patient interactions, or clinical processes).
- Apply managed care contracting tips to close risk gaps and improve positions existing and new payor contracts.
