A Long Day’s Journey into Value-Based Health Care

Download this case study and learn how one ambitious health plan provider is delivering on its value-based health care mission.

At its core, the goal of value-based health care is simple: deliver higher quality care at a lower cost by focusing more on the value of care provided rather than transactional care. Essentially, this is the shift away from fee-for-service to value-based reimbursement. However, this shift is far easier said than done. Challenges spanning from legacy systems, contracting and risk sharing issues, and a lack of actionable analytical insight all contribute to many organizations lacking the ability to engage in value-based health care initiatives or, at best, they engage in limitedscope pilot programs.

These challenges were not lost on a regional health care organization (both a health plan and a health system) that serves approximately half a million members. The organization, however, was committed to finding ways to solve these challenges and deliver on its mission of providing value-based health care through long-term clinical performance and risk-sharing agreements with its providers. This is the story of their journey into improving care coordination, clinical performance and cost of care.