Value-Based Risk Bearing Care & Care Mgt Capabilities

01/25/2022 Collected, modified by Valmeek Kudesia; blatantly inspired from Ian Chiang, FlareCapital

Technology Infra & Pop-Health Management Tech

Enterprise data architecture and data aggregation

• Data integration and exchange (including interoperability)

• Risk stratification and population health analytics

Data analytics and reporting/presentation capabilities

• Automated

• Self-service

• reflection to [[data-omnivorous-platform-healthcare]]

Care management and care coordination solutions

Member/patient engagement solutions

Business intelligence and analytics capabilities

• Operational performance

• Value-based contract management

Contract-level analytics capabilities for TCOC analytics

Pop Health, Care Mgt, Patient Engagement, and Benefits Admin

Population health analytics & individual patient analytics

• Risk adj/stratification

• Predictive/prescriptive modeling

Clinician training and education services

• Team-based care enablement

• Evidence-based protocol education and adoption

• Appropriate clinical documentation and education

• Upskilling lower and mid-level clinicians

• FFV/VBC value optimization services

Gaps in care/care gap closure

• Stars management, P4Q

• Performance and cost initiatives design+exec

Care management services

• Case management, Care coordination (Medical+BH+SDOH)

• Gap closure services and resource augmentation

  • Mbr+prov oriented programs

• Collaborative care enablement

• Transition-of-care (TOC)

• Disease+complex care mgt (clinic, home, virtual)

  • Chronic conditions management

  • Behavioral health. Disease-specific

• Medication therapy management, adherence, and reconciliation (in-office, at home or virtual)

• Utilization management

• Referral management and support

• Other home-based care and care delivery services (as care extension)

  • Annual wellness visits

  • Chronic condition management (via telehealth and remote monitoring)

  • Palliative care

  • On-demand urgent care

  • Companionship/loneliness alleviation

  • Hospital-at-home

Value-added Admin, Network, Practice Mgt for [[all participants]]

Network construction, management, and operations services

• Network strategy and optimization

• High-performing specialist recruiting, contracting, credentialing (i.e., for multi-specialty IPAs and health systems)

• Post-acute care network management

• Community-based Social determinants of health (SDOH) network management

Health plan value-based contract Negotiation, Management, and Advisory

Population health management and value-based contract management education

Transformational services and training

• Operations workflow redesign and enablement

• Technology implementation, enablement, and adoption

• Financial and business transformation

Practice Management services

• Claims processing and/or claims payments if also payor

• Revenue cycle management (RCM)

• Scheduling and appointment management

• Workflow (administrative) automation and digital assistance

• Group purchasing services

• Patient acquisition and multi-channel marketing services and management

• Technology RFP and asset management

Incentive design

Analytics enablement/analytics-as-a-service

Member/patient services

• Enrollment, eligibility maintenance

• Call center operations

• Health plan navigation and benefits education