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Surviving and thriving under hybrid reimbursement models

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Surviving and thriving under hybrid reimbursement models

September 28, 2017

Regardless of current political uncertainties, and federal agency backtracking on implementation of bundled payments, no-one is in doubt that value-based care and reimbursement is the future of the healthcare system.

Guest blog: Pre-sales NHS discussions: The importance of good preparation

March 29, 2017

Recently I joined representatives from Lumeon on a visit to Chelsea and Westminster Hospital NHS Foundation Trust’s maternity services. Our mission was to discuss post-natal patient management solutions and to see if Lumeon's Care Pathway Management platform could help digitize and improve efficiency within this particular pathway. From the Lumeon side, we had a Senior Account Executive, Stephan Zentgraf and his team, while Chelsea and Westminster hospital was represented by a Consultant Obstetrician.

Healthcare, Engagement & Communications

January 12, 2017

by Mike Wilkinson It’s been a few months now since I’ve been in healthcare so I thought I’d provide some perspectives on how the healthcare and communications industries interact and their potential long-term inter-dependencies. It’s a complicated and rapidly evolving picture but one that is increasingly converging. Different Swim lanes: I think the first thing […]

Rethinking Healthcare Delivery for Private Sector

December 8, 2016

Rethinking Healthcare Delivery for Private Sector By Mike Wilkinson We have a problem in the UK. We are conditioned to the concept of being rationed when it comes to healthcare. Demand is overwhelming and the system puts in place various methods of inertia to manage the availability of supply, which has conditioned the consumer that […]

Transforming Population Health Management With CPM

November 30, 2016

By Mike Wilkinson, VP Marketing and Product Management Today we announced the launch of version 2 of the Lumeon Care Pathway Management Platform. A central theme of this release is the ability to automate the management of millions of pathways enabling care on a scale not seen before in the industry. The next phase of […]

Six ways our platform can help private providers work more effectively with the NHS

October 18, 2016

By Justin Thomas As the NHS struggles with overwhelming pressure on resources, there has never been greater opportunity for private providers to provide contracted services. That said, Trusts and CCGs are becoming more demanding of private providers, who must demonstrate that they can manage fluctuations in patient volumes, provide the most efficient service at the […]

How to maximise your referral volume with eRS

October 7, 2016

By Mike Wilkinson, VP of Marketing and Product Last year the NHS launched its e-referral service (eRS),  the system that allows private healthcare providers to advertise their appointment slots and receive referrals electronically from the NHS. The simple web based application processes an estimated 40,000 electronic referrals every day (about 50%), and the NHS is […]

Spire’s approach to Care Pathway Management

August 16, 2016

This June, Dr Jean-Jacques de Gorter, Group Medical Director at Spire Healthcare gave a headline talk at our Catalyst conference. We caught up with Dr de Gorter after the event to get a brief summary of Spire’s approach to Care Pathway Management. Spire have been implementing clinical care pathways for the past ten years in […]

In a new 3-part series, Corrina Kane, our Head of Strategic Marketing, investigates the pursuit and real-life application of value-based care in the US healthcare market. Interviewing a range of leading executives across the provider and payer ecosystem, she looks to uncover how value-based care is being practiced and developed on the ground, and the challenges of improving quality of care in an environment of cost reduction.

In part 1, we address the difficulties providers face in the long period of transition from fee-for-service to value-based reimbursements, and identify strategies to thrive in this hybrid world.

Surviving and thriving under hybrid reimbursement models

Regardless of current political uncertainties, and federal agency backtracking on implementation of bundled payments, no-one is in doubt that value-based care and reimbursement is the future of the healthcare system. By its very nature, this new way of delivering and paying for healthcare is the antithesis of the old world of fee-for-service and payment for activity. As with all system change, there are winners and losers. As in nature, hybrids are commonly less viable than their parent species. Those surviving are operating in increasingly commoditized markets with high fixed costs in an environment of reduced reimbursement. Many are having to find creative ways of delivering care whilst maintaining profitability and offsetting reduced margin by cutting back on operational costs to stay in business. The fittest are thriving. Those with innovative, forward-thinking and well-resourced leadership have been investing ahead of the curve and are implementing a host of transformations to be successful in the new world. Some common characteristics include: rethinking care delivery models, infrastructure change, managing care at a population level and leveraging data and technology to reduce operational and administrative burden and implement new ways of working. This article explores case studies of organizations thriving in value-based transition and how they’re achieving success.

To read the full article in Beckers CFO Report please click here.