Connecting the Dots of Population Health

Everyone in the healthcare industry is impacted by one or more alternative payment models. Widely viewed as the primary tool for driving down costs, improving quality and providing the funding mechanisms for long-term population health objectives, creating a unique strategy for success in the Alternative Payment Model (APM) domain has never been more challenging, or essential.

DHG Healthcare’s kә’nekt solution is uniquely designed for organizations looking for the deep insight, applied analytics, tangible creativity and practical discipline to guide their journey from a participant in a voluntary or mandatory program to a fully functioning population health organization.

KNOWLEDGE SHARE

HOW WE SERVE

DHG Healthcare has built the most sophisticated analytics and advisory platform for CMS APM programs in the industry and has served many of the leading health systems across the market. Our comprehensive solutions include data analytics, advisory consulting, implementation planning, program design, execution support and financial management. We have focused most heavily on CMS-managed APMs through which Medicare FFS beneficiaries are piloting new models of care delivery and reimbursement. We serve more than 300 hospitals and post-acute clients.

Establishing a baseline understanding and identifying opportunities for an organization’s population health strategy is contemplated at the beginning of the engagement. This assessment would allow for insight into capabilities and performance in a number of key areas, laying the foundation to develop an informed plan of action for management.

DHG Healthcare has developed proven approaches and tools to support gainsharing, post-acute networks, care management programs and clinical documentation/coding improvement throughout various episodic care models. We work with your organization as you transition into these episodic models to help providers to prepare quickly, scale effectively and launch successfully in these value-based care models.

DHG Healthcare has significant experience in supporting the development of evidence-based care management program strategies to ensure beneficiaries receive the most efficient, appropriate and person-centered care. We utilize a best practice Care Management Blueprint to provide directional assistance in program development, clinical standardization and clinical integration to improve clinical, quality and financial performance while generating efficiencies in care management throughout the care continuum.

DHG Healthcare is focused on assisting providers in achieving their financial and clinical goals within standard fee-for-service and alternative (including episodic) payment models. As payment models evolve for both government and commercial payers, organizations must develop additional competencies to risk-adjust patients, accurately depicting their severity of illness and acuity. DHG Healthcare has deep experience in assisting organizations as they transition their legacy approaches to Clinical Documentation Improvement and Coding to a contemporary focus, which incorporates proper capture of Hierarchical Condition Categories (HCCs), in addition to the accurate assignment of Principal Diagnosis and MS-DRGs.

DHG Healthcare guides clients in navigating their individual path towards risk capability. This is accomplished through a combination of dynamic analytic tools and focused advisory services to improve the patient experience of care, improve the health of populations and reduce the cost of healthcare while aligning an organization’s mission and strategy with the pursuit of value-based care.

As the healthcare landscape continues to shift towards value-based care, alternative payment models have become increasingly popular. Whether organizations are participating in mandated or voluntary APMs, DHG Healthcare’s advisory services are designed to support participation decisions, track program performance and identify financial and clinical opportunities.

  • Bundled Payment Model and Episodes of Care Advisor — Leveraging our extensive bundled payment experience through a combination of dynamic analytic tools and focused advisory services, DHG Healthcare provides data-driven advisory services in the areas of care management, CDI and coding and post-acute care, program compliance and gainsharing. These services are supported by analytic dashboards organized for executive and operational stakeholders, providing both high level summaries and granular drill-down capabilities. DHG Healthcare supports providers in model participation decisions and in tracking progress towards specific organizational goals over the lifespan of the model. Example models include:
    • BPCI-A: Bundled Payment for Care Improvement Advanced
    • CJR : Comprehensive Joint Replacement Program
    • OCM: Oncology Care Model
    • Custom Commercial Bundle Arrangements
  • Population Based Model Advisor — Today, hundreds of organizations participate in APMs aimed to manage total cost of care and quality for specific patient populations. These models offer various options for financial risk, payment capitation and benchmark methodology. DHG Healthcare has developed a suite of service offerings that allow for quick and easy analysis of model specific data, providing tailored solutions to help our clients answer questions related to potential participation and performance tracking in the following models:
    • Medicare Shared Savings / Pathways to Success Program (ACO)
    • Next Generation ACO Model
    • Direct Contracting Model
    • Primary Care First Model
    • Custom Commercial / Medicare Advantage Contracts

DHG Healthcare provides data analytic solutions to numerous Accountable Care Organizations (ACOs) across the country. Our team has developed a comprehensive analytic reporting suite, which allows users to analyze the variables key to achieving success in the delivery of value-based care for ACO populations. Collectively, this analytics suite of reports helps participants understand the total picture of utilization and expenditure based opportunities within their ACO.

EXPERIENCE

DHG Healthcare has been at the forefront of the APM domain for more than five years. No other consulting firm advises more clients in the latest BPCI-A program or is more grounded in the technical knowledge that success in the APM space requires.

We are honored that organizations from across the country seek our guidance as they prepare for their journey to success with both near-term APM work and long-term population health ambitions.