Vital signs: What to consider before launching a provider-sponsored health plan
Half of US health systems are contemplating owning a health plan. What should they consider before launching a provider-sponsored health plan in the New Health Economy?
Manage population health
Is population health working as you planned? Is big data posing challenges?
The healthcare market is rapidly shifting from volume-based care to value-based care (VBC). Moving forward, quality and cost will determine the appropriateness of the care that’s delivered. Many forces are driving this change, such as Center for Medicare and Medicaid Services (CMS) penalties, accountable care organizations (ACOs), risk-based payment arrangements and health insurance exchanges.
Like other organizations, you need to adapt. Converting to VBC requires different capabilities. What will it take for you to succeed?
- An operating model to keep you financially whole
- The ability to act as a risk entity managing the total cost of care while improving clinical outcomes as demonstrated by outcome measures
- Insight to predict your financial risk exposure based on the population you're managing
PwC can help you transition to a customized VBC model and manage your population health based on your strategic goals and market position.
How PwC can help
PwC provides its clients with population health and value-based care services, including:
- Strategy
- Care model design
- Product design
- Network design/partnerships
- Operational transformation
- Population health management
- Data and analytics
- Risk management
- Talent management
*Consulting to Healthcare Payers and Providers: Digital Information for Alternative Care Models”, ALM Intelligence, 2015.
Insights
Beyond the hospital walls: Post-acute care opportunities and strategies
With the move to value-based care, post-acute assets and capabilities will become a more integral part of any action plan.
Accelerate innovation on behalf of the health consumer
Introducing DoubleJump Health™, PwC's new consumer health accelerator. We're combining our business innovation expertise with our leading technological knowledge and digital tools to change how care is delivered.
