CASE STUDY
Fee-For-Value Market and Operational Capability Strategy Development for Large Health Care Payer
THE CHALLENGE
Strategic guidance needed for fee-for-value arrangement
A multi-plan, multi-state health care payer needed strategic guidance to administer fee-for-value arrangements more effectively and efficiently to support the plan’s broader organizational strategy and market-specific operational execution plans.
Our team of healthcare experts facilitated collective intelligence working sessions with key client and partner stakeholders to identify future-state operational capabilities.
OUR SOLUTION
Comprehensive Value-Based Care operational catalog, combined with market-specific intelligence builds future state operating model
Optimity led the client and its partners through a comprehensive current-state assessment of the enterprise, interviewing key enterprise and market-specific stakeholders to understand the plan’s current fee-for-value operational capabilities. We then developed an operational gap analysis, evaluating the operational readiness of the plan’s fee-for-value arrangements.
Our team of healthcare experts facilitated collective intelligence working sessions with key client and partner stakeholders to identify future-state operational capabilities. The outcome of these working sessions was a fee-for-value roadmap and rollout prioritization schedule guided by the payer’s specific provider market readiness.
TOOLKIT
Stakeholder Interviews
Collective Intelligence Workshop
Comprehensive Value-Based Contracting (VBC) Operational Requirements Catalog and Assessment Rating Tool
Fee-for-Value Rollout Schedule and Roadmap
THE RESULTS
Developed a full execution roadmap to achieve desired operating model
Created a targeted future state operating model, influenced by current state operations as well as market and regulatory imperatives
Created investment estimates of the relative cost for shared savings, Pay-for-Performance and capitation models
Designed an enterprise-wide center of excellence that aligned all fee-for-value activities to create a cohesive program
