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 and innovators 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 and value-based 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:
- Medicare Shared Savings Program
- ACO REACH
- Kidney Care Choices (KCC) Model
- Oncology Care Model (OCM)
- States Advancing All-Payer Health Equity Approaches and Development (AHEAD)
- Integrated Care for Kids Model
- Private payer-provider risk-sharing arrangements in Medicare Advantage, Managed Medicaid, and ACA/commercial markets
- Medicare Advantage Value-Based Insurance Design Model (VBID)
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