In today's healthcare environment, providers are increasingly being asked to take on risk and deliver value. Payers are shifting from pay-for-service to pay-for-value at various speeds and degrees. Value-based payment models are being designed and implemented in almost all segments, from government sponsored programs to the private insurance market. Providers often embark on the value journey without fully understanding the potential risk. The Wakely value-based payment offerings help risk-bearing entities disentangle complex value-based payment models and manage financial risk, so that providers can focus on what they do best - caring for their patients.
Wakely Value-based Payment Services
Strategy and Payer Engagement
We conduct program and product feasibility studies, review VBP contracts and provide negotiation support. We conduct financial projections and evaluate provider network changes. We also serve as trusted data intermediaries between providers and payers.
Performance Evaluation and 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, and population health insights.
Operations and Other
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, and regulatory licensing support.
Programs We Serve
We serve clients participating in a variety of programs and arrangements.
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Primary Care First
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Medicare Shared Savings Program
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ACO REACH
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Kidney Care Choices (KCC) Model
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Oncology Care Model (OCM)
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Private Payer-Provider Risk Sharing Arrangements in Medicare Advantage, Managed Medicaid, and ACA/Commercial markets
Provider Tools
WMACAT (Wakely MA Competitive Analysis Tool)
WACACAT (Wakely ACA Competitive Analysis Tool)
Wakely RSO (Risk Score Optimization)
Hospital Price Transparency Tool
WRI-ACO (Wakely Risk Insights – ACO)
Payer-Provider Joint Economics Model
WMRAT (Wakely Medicare Repricing Analysis Tool)
Provider WAHOO
Coming Soon
Network Optimization Tool
Data:
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100% Medicare FFS Data Set
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5% Medicare FFS Data Set
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Medicare Advantage Encounter Data
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Part D Event Data
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Long Term Care Minimum Data Set (MDS)
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WACA (Wakely ACA) Data set
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Marketscan(TM)
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Proprietary De-identified Client Data
Industry Insights
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CMS "Capping" ACO Potential: The Need for Capped Regional Risk Scores
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Wakely Risk Insight for the Medicare Shared Savings Program: Performance Year 2021 Results
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Proposed Benchmarking Updates to the Medicare Shared Savings Program
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Demystifying the Retrospective Trend Adjustment in Direct Contracting and ACO REACH
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Health Equity Adjustment under ACO REACH Program
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ACO REACH - Direct Contracting Redesigned with Enhanced Focus on Health Equity
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Understanding Your ACO's Benchmark
Our Value-based Payment Experts
Interested in Working with Us?