Value-Based Payment & Delivery Systems

Invaluable guidance for value-based payment and delivery systems.

Now that value-based payment (VBP) models are being implemented in almost all segments of the industry, providers often embark on the value journey without fully understanding the potential financial risks.

With consulting services and analytical tools, Wakely helps our clients navigate complex value-based payment models and manage financial risk. This allows providers to focus on what they do best — caring for their patients. 

Wakely actuaries and consultants offer an in-depth understanding of value-based payment models and delivery systems, and have assisted countless providers, payers, and other VBP entities. 

Wakely’s Value-Based Payment and Delivery Systems Services

Strategy & Payer Engagement 

Services include:

  • Conducting program/product feasibility studies
  • Reviewing contracts and providing negotiation support
  • Making financial projections and evaluating provider network changes
  • Serving as trusted data intermediaries between providers and payers 

Performance Evaluation & Improvement

We provide analytics that VBP participants rely on to manage performance, including:

  • Provider and patient-level scorecards
  • Benchmarking
  • Risk adjustment and quality performance analysis
  • Utilization and cost analysis
  • Population health insights

Operations & Other Areas

Our established, yet customizable models and tools enable efficient methods for:

  • Claims data processing
  • Unpaid claims reserving
  • Risk adjustment accruals
  • Capitation and shared savings distribution
  • Year-end statements
  • Regulatory licensing support

Investment Services

Wakely provides strategic advice, analytics, and industry-leading tools to help empower your market strategies and inform decision-making. 

Support for a wide range of programs.

Wakely has extensive experience teaming up with state Medicaid Associations and the underlying member plans. We serve clients participating in a variety of programs and arrangements, including:

Unique products and tools.

Wakely has developed these industry-leading products and tools, which empower our clients to make highly informed strategic decisions.

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Wakely Analytics Health Operations Optimization (WAHOO)

Helps payers and providers optimize financial performance with a complete package of services and tools.

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Risk Score Opportunities (RSO)

Identifies and prioritizes members who are most likely to have a condition that has not been coded.

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Wakely Medicare Advantage Competitive Analysis Tool (WMACAT)

Allows health plans to compare Medicare Advantage benefits and market information at the national, state, and county levels, to evaluate plan design and performance.

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Wakely Medicare Repricing Analysis Tool (WMRAT)

Aids the comparison of payment rates across multiple lines of business, categories of service, geographic locations, and providers.

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Healthcare Industry Insights

Michael CohenBy Michael Cohen
Michael CohenBy Michael Cohen