Value-Based Reimbursement

Value-Based Reimbursement

As the traditional reimbursement model evolves from fee-for-service to a more value-based approach, healthcare organizations are facing massive upheaval in their respective business models. Federal policy swings also make it difficult to predict the most stable path forward.

Waller attorneys understand the probable financial implications and inherent challenges companies face in the decision to transition their reimbursement to one based on quality of care delivered versus the services provided. We help clients assess their models and make appropriate decisions given their strategy.

Accountable Care Organizations

A key component of healthcare reform is the support received by innovative delivery models to improve coordination of care for Medicare patients. Accountable Care Organizations (ACOs) have been the most widely publicized of these new models. Recognizing the significance of this new model for integrated care delivery, Waller has underwritten proprietary research on the response to ACOs within the healthcare industry and has conducted numerous programs and seminars on the topic, a number of which were in partnership with Modern Healthcare. In addition, we are helping our clients create a number of relationships that, while not designed to participate in the Medicare shared savings program, focus on coordinating care, whether through bundled payment programs or other innovative models.

Regulatory and Operational Experience

Our healthcare clients rely on our vast expertise in regulatory and operational matters when evaluating the issues and opportunities related to forming and participating in Medicare and private-payor ACOs. As the industry moves into the post-PAPACA era, Waller is actively engaged in assisting providers to address issues that are critical to their business model and how they care for their patients.

Related Experience

HCA enters into Bundled Payments for Care Improvement (BPCI) Advanced model

Assisted HCA in preparing for and commencing participation in Bundled Payments for Care Improvement Advanced model.

HealthCare Authority establishes Hospital Quality and Efficiency Program

Advised the HealthCare Authority of the City of Cullman in establishing a Hospital Quality and Efficiency Program (HQEP) with its medical staff.

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