Value-based Payment Services

In today's healthcare environment, providers are increasingly being asked to take on risk and deliver value. Payers are shifting from pay-for-service to pay-for-value at various speeds and degrees. Value-based payment models are being designed and implemented in almost all segments, from government sponsored programs to the private insurance market. Providers often embark on the value journey without fully understanding the potential risk. The Wakely value-based payment offerings help risk-bearing entities disentangle complex value-based payment models and manage financial risk, so that providers can focus on what they do best - caring for their patients.

Wakely Value-based Payment Services

Strategy and Payer Engagement

We conduct program and product feasibility studies, review VBP contracts and provide negotiation support. We conduct financial projections and evaluate provider network changes. We also serve as trusted data intermediaries between providers and payers.

Performance Evaluation and Improvement

We provide analytics that VBP participants rely on to manage performance, including provider and patient-level scorecards, benchmarking, risk adjustment and quality performance analysis, utilization and cost analysis, and population health insights.

Operations and Other

Our established yet customizable models and tools enable efficient methods for claims data processing, unpaid claims reserving, risk adjustment accruals, capitation and shared savings distribution, year-end statements, and regulatory licensing support.

Programs We Serve

We serve clients participating in a variety of programs and arrangements.

Primary Care First
Medicare Shared Savings Program
ACO REACH
Kidney Care Choices (KCC) Model
Oncology Care Model (OCM)
Private Payer-Provider Risk Sharing Arrangements in Medicare Advantage, Managed Medicaid, and ACA/Commercial markets

Provider Tools

WMACAT (Wakely MA Competitive Analysis Tool) WACACAT (Wakely ACA Competitive Analysis Tool) Wakely RSO (Risk Score Optimization) Hospital Price Transparency Tool WRI-ACO (Wakely Risk Insights – ACO) Payer-Provider Joint Economics Model WMRAT (Wakely Medicare Repricing Analysis Tool) Provider WAHOO Wakely Network Optimization Tool (WNOT)

Data:

100% Medicare FFS Data Set
5% Medicare FFS Data Set
Medicare Advantage Encounter Data
Part D Event Data

Long Term Care Minimum Data Set (MDS)
WACA (Wakely ACA) Data set
Marketscan(TM)
Proprietary De-identified Client Data

Industry Insights

Relevant Materials for Download

Wakely Value-Based Payment Wakely Medicare Repricing Analysis Tool (WMRAT) Wakely Analytics Health Operations Optimization (WAHOO) Wakely Risk Score Opportunities (RSO) Wakely Investment Services Wakely Risk Adjustment Modeling Wakely Network Optimization Tool (WNOT) Wakely Medicare Advantage Competitive Analysis Tool (WMACAT)

More News and Research

Wakely Value-Based Payment Practice on LinkedIn

On this page we will post timely content on value-based payment news, insights, and commentary across the healthcare sector as well as white papers and more.

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