Payer / Provider Innovation
Seizing opportunities in a shifting payer-provider landscape
The continuing transition of the U.S. healthcare system to a value-based market has created opportunities for providers and payers willing to take a fresh look at their traditional business models. Health systems are increasingly becoming insurers—launching accountable care organizations (ACOs), building payer partnerships, initiating private-label products and even launching their own provider-sponsored health plans—and now face the challenge of learning to “think like a health plan”. Payers are increasingly delegating risk through these same structures and offering services to providers seeking insurance expertise in understanding and managing patient populations.
BDC has been developing risk-based contracts between health systems and provider groups, health plans, and employers for over 20 years. We were the first consulting firm to build a clinically integrated network based on performance-risk contracting and since then, have worked on many engagements on both sides of these risk arrangements. We have expertise in all forms of risk-sharing, value-based contracting, including “bundled payment” contracts, and partial and global capitation. We also have considerable experience developing different types of partnerships between payers and providers, or groups of providers (e.g., Super-ACOs) being formed to bring population health products to the emerging retail market.
Learning to “think like a health plan” means developing payer/provider partnerships to bring innovative products to the emerging value-based market.
Meet Our Practice Leaders
Bill has over 25 years of senior healthcare executive and consulting experience, including Booz Allen Hamilton, Marriott, Manor Care and, for the past decade as a Managing Director with BDC Advisors. Bill leads our Payer-Provider Innovations practice, advising clients on a range of value-based reimbursement and population health issues, and has directed strategy engagements for leading academic medical centers and health systems throughout the country.
Alan E. London, MD
Alan is an internationally recognized healthcare leader with over 30 years of experience as a senior business executive, chief medical officer, entrepreneur, and management consultant in the national and international healthcare markets. He has significant expertise in mergers and acquisitions, a proven ability to forge strategic hospital / physician partnerships, and a track record of completing successful healthcare ventures within a variety of healthcare financing and delivery systems.
Finding the ‘Sweet Spot’ in Value-Based Contracts
Featured on the August 2015 cover of hfm Magazine, Bill Eggbeer’s “Finding the ‘Sweet Spot’ in Value-Based Contracts” focuses on the transition to fee for value that is accelerating in healthcare markets across the nation; the time is at hand for providers to develop and implement value-based contracts.