By RaeAnn Grossman

Let’s look at the fundamentals of value-based care.

  • Cost Reduction: 81% of providers view value-based care as a means to reduce the cost of care
  • Quality: Medicare sees that quality and incentive structures are key. CMS paid out $90 million in quality bonuses on the senior population in 2018.
  • Collaboration: The number of joint ventures and co-branded health insurance products has increased by almost 64% in the last three years.
  • Engagement: Over 75% of health systems and nearly 60% of the provider community is participating in some form of value-based care relationship—whether P4P, P4Q, cost-saving, shared-risk, or some other methodology.

When creating the solution, one needs to reflect on the challenges in the planning stages.

  • Provider participation
  • Member engagement
  • Improving administrative financial and clinical performance

Therefore, a value-based solution must contain:

  • Data analytics to predict, illuminate and create repeatable outcomes
  • Clinical, financial, social and operational data, reporting, and a holistic view of the network, entities, and market
  • Provider network management, performance metrics, and planning
  • Patient engagement with preferred outreach methods and intervention strategies

We included all these elements to create Evoke360 along with unique views to offer greater cost controls, premium insight, and strategy impact. Unlike population health systems, our Evoke360 platform truly creates an effective risk-bearing, value-based network.