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How can smaller practices compete in value-based-reimbursement world?

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Medical Economics recently spoke with Daniel K. Zismer, Ph.D., a co-founder and managing director of Castling Partners, a Minneapolis-based healthcare management advisory firm, about how organizations of different sizes can succeed in the value-based-reimbursement world. Among his remarks:

Medical EconomicsThe big question: How can a smaller practice compete with larger practices under value-based reimbursement?

“Mr. Zismer: To play to win in this environment, practices may have to do something many don’t want to do—be part of that larger, more integrated, sophisticated health system that can go upstream while contracting with both insurance and the government.

“The average health system has fewer than five payers that matter to the whole revenue stream in a major way. With such a consolidated payer marketplace, there really isn’t a payer interested in trying to aggregate and contract separately with hundreds of small medical practices.

“Payers are more attracted to larger, more integrated sophisticated systems of care delivery that have a more resilient economic model. Smaller practices should get organized and positioned to play in this era of experimentation, understanding that health insurance providers are interested in creating value-based programs. They may not, however, be interested in creating models and methods so that any provider of any size and scale can participate with them.”

To read the whole interview, please hit this link.


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