In order for value-based payment models to be sustainable, they need to be designed in a way that is fair to all parties involved. Providers participating in value-based payment models such as capitation or shared savings take on a substantial portion of health insurance risk for the patients that are attributed to them through these programs. Furthermore, employers and insurers with a stake in these arrangements ought to have a keen interest in creating a viable payment mechanism that creates continuity of high-value services for members and meets long-term strategic goals. Care should be taken in the development of value-based payment models to ensure an appropriate balance of upside and downside risk for providers.

This session explores and quantifies the extent to which risk adjustment can reduce the inappropriate variation in reimbursement that is due to underlying patient morbidity, and the residual risks of inaccurate payment that remain after the application of risk adjustment. Quantifying the residual risks can invite the opportunity for further refinement of the payment contract to minimize remaining risks.

Please join us Wednesday, June 8th, 2016 at 2 PM Eastern as Milliman’s Colleen Norris and Stoddard Davenport address applying risk adjustment to value based payment models in the HealthcareWebSummit event: Risk Adjustment Techniques for Improving Value-Based Payments. Click here for detailed information and to register or call 209.577.4888.