Services

Integrated Networks and Contracting Entities

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For delivery organizations wishing to change existing contracting and alignment, we have deep expertise in designing and launching provider networks, such as Independent Practice Associations (IPAs), Accountable Care Organizations (ACOs), Clinically Integrated Networks (CINs), and Physician/Hospital Organizations (PHOs).

As healthcare continues the shift from volume to value, high performing provider networks enable value-based payment arrangements, and enable appropriate governance for consistent clinical care delivery, financial integration, and critical success factors. We partner with leading legal firms nationwide to leverage proven entity mechanics (e.g., operating agreements, participant agreements) in order to streamline the development of new contracting entities. Services for contracting entities might include:

  • Evaluation and recommendations for critical decisions for contracting strategy and entity design

  • Entity governance model design and redesign

  • Evaluation of existing contracting structure to ensure alignment with current goals, as well as future business objectives

  • Evaluation and decision-making guidance on alternative payment models, such as the Medicare Shared Savings Program (MSSP) ACO and commercial ACO contracts

  • End-to-end project and planning design, development and implementation of contracting entities supporting potential new ventures

  • Infrastructure plan development, including key recommendations for technology functions, including data warehouse, population health analytics, and care management