b'VALUEWhile COVID negatively impacted value-based arrangements, their strategic importance has never beenprovider organizations that self-insure their employee health plan bears even more significant financial risk. Identifying all types of VALUE current risk arrangements and the corresponding capabilities to support their success is an important first step.clearernor the gaps organizations have in their capabilities to execute on those arrangements Move with haste but dont rush. Few organizations rush into critical decisions which alter their core business models. Rather, most MAKE HASTE, NOT WASTE: INTENTIONAL ALIGNMENT OF APM GOALS AND CAPABILITIES organizations move without haste, deferring what Stephen Covey called Quadrant II activities that are important and not urgent for another point in the future. A hybrid approach to the two aforementioned extremes is recommended; create a long-term APM Beginning withand in some instances pre-datingthe adoption of the Affordable Care Act in 2010, healthcare providers have tested and adopted countlesscapability development plan and make regular, demonstrable progress toward achieving the capabilities that support APM goals.iterations of alternative payment models (APMs.) Each and all of these APMs seek to achieve the Triple Aim of improved health of populations, lower cost of care, and better care experiences.By many accounts, American healthcare providers have made progress toward these goals. According to an industry-wide study conducted by the Healthcare Payment Learning and Action Network, 35.8% of total U.S. health care payments were tied to APMs in 2018, a steady increase from 23% three years ago. Despite industry progress, persistent fundamental challenges remain. In a recent DHG Healthcare survey of 87 senior healthcare executives across the United53%48%89%94% States, 89% of respondents agreed that engaging in more APMs is a strategic need for their organization, yet fewer than half (48%) of respondents agreed that their organization was capable of meeting this strategic need. In short, many providers fundamental capabilities fall short of their goals and needs.Matching Capabilities with Strategic Needs The results of DHG Healthcares survey are at once both unsurprising and solvable. Our experiences advising provider clients suggest that interest has outpacedof value basedsay their currentbelieve that theirsay that their capability for several years. Common themes in this mismatch include: arrangementsorganizationalorganization needsoperational riskLimited downside prevents meaningful change. Providers that are engaged in (a) upside-only financial risk models, (b) APMs with predictable financialarbitrage, and (c) APMs whose financial risk is subsidized by third parties have limited rationale to invest in implementing changes of any sort. Too often, the impacted by capabilities to engage intolerance isresults from inconsequential participation in APMs are few and fleeting. COVID-19 weredo not match more value-basednot in line withOver-reliance on technology platforms. From robust EMRs to the latest predictive analytics tools, healthcare providers have been looking for an elusive, negatively their strategicarrangements their organizations turnkey solution for years. Despite these developments, informed behavioral change remains the most effective strategy. Focus first on net-accretive capabilities. Many capabilities that support APM success also benefit providers traditional FFS businesses; there are pockets of impacted needs value-based mutual benefit. The most common example is clinical documentation improvement (CDI) initiatives that improve the depiction of patient acuity while also aspirationsgenerating incremental FFS revenue for the provider. Understand current risk arrangements. Every provider in the U.S. is involved in alternative payment models. Even at its most basic, programs like the MeritBased Incentive Payment (MIPS) program, the Value-Based Purchasing (VBP) model, the Readmission Reduction Program (RRP), and Hospital AcquiredCondition (HAC) penalties are all mandatory risk-bearing arrangements that impact all physician and acute hospital providers. Even more significantly,Assurance/Tax/Advisory/dhg.com 12 13 2021 Dixon Hughes Goodman LLP. All rights reserved. DHG is registered in the U.S. Patent and Trademark Office to Dixon Hughes Goodman LLP.'