While it’s too early to tell, many industry leaders speculate that the financial impacts of the COVID-19 pandemic will push providers to take a more serious look at value-based care models.
And as interest in those models grow, data analytics startup Apervita has rolled out new technology tools to help providers and payers better manage the complex contract arrangements of these payment models.
The solution for providers and payers, called QPay, is designed to improve transparency in value-based care contracts, the company told Fierce Healthcare.
Shared-risk payment models require the ability to maintain and manage a growing number of contract terms.Key terms that figure into the final reconciliation of value-based contracts can include cost targets, excluded services such as behavioral health services or pharmacy claims, and stop-loss methodology.
There was a strong surge of interest in moving to value-based care models at the outset of the pandemic when providers saw volumes flag and financial pressures grow amid stay-at-home orders, according to UnitedHealth Group CEO David Wichmann while speaking at a conference last month.
Federal official Seema Verma, who heads the Centers for Medicare and Medicaid Services (CMS), also said Tuesday during the HTLH 2020 virtual conference that the agency “isn’t shying away from value-based care” but hinted that CMS wants providers to take on financial risk at a faster pace.
But there is often friction between providers and payers due to the lack of understanding around the complexity of contract terms and this can lead to