GETTING FROM PRE-ACA TO POST-ACA
This Cartesian Solutions, Inc.™ Service, which is typically contracted as part of one or more of the other client Services, helps accountable provider systems set priorities and timelines for identified value-added changes in care delivery processes and patient assist and support services as they transition from volume-based to financially sustainable value-based patient care.
Up to this point, Cartesian Solutions, Inc.™ services have focused on assistance with: 1) creating health care services in which provider system patients can access the medical and behavioral health care most likely to stabilize their health thus reducing total health service use and improving post-ACA system profitability, 2) introducing value-added medical and behavioral health assistance and support for high need and high cost patients with comorbid conditions, and 3) connecting service #1 and #2 by facilitating development of financially sustainable Complex Care Programs for patients with the greatest health need and service use. Unfortunately, services #1 through #3 are not turnkey. Changes in care delivery procedures and corresponding payment processes do not happen overnight. Rather, prioritization and sequencing of internal care delivery initiatives and provider contracting, often with timelines measured in years, is required for accountable provider systems to achieve their ultimate goal of maximal total population health while maintaining profitability.
Typical Cartesian Solutions, Inc.™ consultations related to this Service for accountable provider systems include:
- Utilization of information derived from Cartesian Solutions, Inc.™ Services #1, #2, and/or #3 to create a big-picture vision of the provider system’s future state;
- Recommendations on prioritization of the steps and timeline needed for:
- Incorporating value-based and coordinated medical and behavioral health services,
- Changing to integrated medical and behavioral health provider insurance contracts, and
- Setting up high intensity cross-disciplinary assist and support programs, such as Integrated Case Management (ICM)
Such steps and timelines support early deployment of doable components leading to cost savings first but long-term value-added components soon follow based on an understanding of the health system contracting business cycle.
- Ongoing participation by Cartesian Solutions, Inc.™ experts in decision making conversations during the project deployment process.
- Creation of a dashboard for monitoring progress of the accountable provider system health care and support initiative.
All consultations are customized to the needs of the client. Contact Us to discuss your needs and the potential for a consultation.