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Reform-Proofing Your Managed Care Contracting Strategy

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Executive Insight

Value-based payment methodologies are under careful study by both the Centers for Medicare & Medicaid Services (CMS) and commercial payors. As reimbursement trends shift from payments based on fee-for-service (FFS) to a more value-based system, risk will shift from payors to providers. The first step in developing a successful contracting strategy is to prepare for that shift by assessing the architecture, advantages, and disadvantages of value-based payment models to determine which model will help meet your organization’s strategic objectives now and over time. This article discusses four primary payment models that are garnering the most attention and outlines three steps to navigate changes and develop a successful contracting strategy.

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