ATLANTA, May 2, 2016 /PRNewswire/ -- Wellcentive, a leader in value-based care solutions, today announced the launch of a free tool to calculate the real cost of delaying the shift from public and private payer volume to value-based care (VBC) and reimbursement.
The Cost of Inaction calculator helps organizations estimate the impact, based on national benchmark data for health services and the organization-specific data users submit, of delaying effective implementation and management of VBC practices.
Private payers have historically followed Medicare's lead regarding new payment models, and The Centers for Medicare & Medicaid Services (CMS) continues to roll out VBC initiatives with significant incentives. There is not just an opportunity cost for those who delay, however – payers are also imposing penalties and driving providers toward more financial risk.
As an example, a physician group with $200 million in revenue, 350 providers, and a payer mix of 30 percent Medicare and 30 percent commercial will experience a cost of inaction, using a conservative analysis, of $20 million over five years.
"The time for value-based care is now, and hesitation will have a significant current and future financial impact," said Tom Zajac, Wellcentive CEO. "We are providing this free tool as part of our industry advocacy, to help model the economic impact of delay and to demonstrate the potential gains through adoption. It can also serve as a strategic framework for decision making – organizations can select what programs they think may be beneficial to participate or invest in, and see the potential cost of inaction."
Value-based care is rapidly becoming both a catalyst for change and the industry standard:
- The Medicare Access & CHIP Reauthorization Act of 2015 (MACRA) proposed rule has been issued, which emphasizes advanced payment models, expanded quality and registry reporting and population health management.
- Bundled payment programs – also included as MACRA APMs – are expanding among payers.
- CMS recently announced the Comprehensive Primary Care Plus (CPC+) payment model – a MACRA Advanced APM – the agency's largest multi-payer initiative for value-based primary care. The CPC+ model is schedule to begin implementation in 2017 across up to 20 regions targeting 20,000 physicians and approximately 25 million patients.
To access the Cost of Inaction calculator and learn more about the methodology, please visit www.wellcentive.com/cost-of-inaction-calculator.
Since 2005, Wellcentive has driven quality improvement, revenue growth and business transformation for providers, health systems, employers and payers transitioning to value-based care. Our highly scalable, cloud-based and value-driven population health management solution provides long-term partnership services to impact clinical, financial and human outcomes. Recognized as a leader in population health management in reports by IDC Health, KLAS and Chilmark, Wellcentive helps our customers provide care management for more than 30 million patients and achieve more than $500 million annually in value-based revenue.
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