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Planning Strategies to Bridge Fee-For-Service and Value-Based Care

By Truven Staff
Linda MacCracken imageIn today’s market, providers planning for service reconfiguration are focusing on several areas: physician networks, outpatient networks, payer risk initiatives, acute care provider partnerships, and pre-/post-acute care provider partnerships. Driven by healthcare reform, the provider delivery system is rapidly consolidating and contracting in new ways. With the new risk and value-based reimbursement incentives, hospitals and health systems have to develop comprehensive care networks that will provide the right care, at the right price, in the right setting.

So how do providers begin to bridge fee-for-service and value-based care? With strategic planning. In fact, strategic planning has never been so important. Being willing to make new connections and take risks will be hallmarks of a successful planner.

Using the same approach to strategic planning and involving the same planning stakeholders won’t work under healthcare reform. Planning processes need to be more flexible, frequent, and adaptive to ensure that hospital leaders have a strategy for acquiring and delivering care through partnerships.

How can hospital planners get started?
  1. Engage a larger group of internal stakeholders in the strategic planning process, such as physician leadership; fiscally aligned physicians via the physician-hospital organization (PHO) or employed group practices; and senior clinical and operational leaders.
  2. Prepare capacity for the arrival of the newly insured.
  3. Coordinate the outpatient network with the strategic business plans.
  4. Leverage performance best practices.
  5. Establish provider partnerships with pre- and post-care delivery providers.
  6. Assess payer risk initiatives by episode-driven care.
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Linda MacCracken
Vice President, Advisory Services

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