ACO and MCO Post Conversion Optimization
Continually progressing to the next level of clinical, financial and operational improvement is critical to maintain success, outpace the competition, and remain relevant in the ever-changing field of healthcare. BHM is pleased to offer Post Conversion Optimization for those organizations which have successfully transformed into a Managed Care Organization or Accountable Care Organization and are looking to take their organization to the next level.
ACO Post Conversion Optimization
We understand that making the shift to an Accountable Care Organization is difficult. Whether you are a private Accountable Care Organization or a Medicare Shared Savings Program ACO, we can assist you in finding solutions that will ensure that your current activities are aligned to boost margin growth, balance risk, and provide value based care.
Our scaled solutions offer a comprehensive platform for ACO optimization across clinical, financial, and operational performance metrics, and our consultants understand the balance between quality of care and financial viability.
If you are already an ACO but are looking to identify actionable opportunities, BHM can assist you with the following:
- Alignment of Organizational Objectives
- Clinical, Financial, and Quality Improvement Initiatives
- Review of Risk Strategies and Contracts
- Financial Performance Assessment and Optimization Plans
- Data and Reporting assistance to capture critical reporting metrics, and internal KPIs that inform change and clarify opportunity
- Value Based Service Alignment
MCO Post Conversion Optimization
BHM has a fundamental understanding of Managed Care, and has assisted some of the largest Managed Care Organizations, from initial conversion from Local Management Entities to post conversion optimization. Continuous Improvement in the Managed Care Arena has assisted our clients in the following way:
- Provision of URAC Accredited IRO Services
- Accreditation Maintenance – post accreditation milestones and guidance
- Clinical Improvements – through enhanced training and application of clinical guidelines for Care Management staff
- Care Coordination – implementation of integrated and effective approaches to Case Management
- Financial Sustainability – financial optimization through work flow analysis and business process engineering (e.g., Claims, UM, Grievances and Appeals, etc.)
- Managed Care Reporting – utilization of relevant statistical information to ensure budgetary compliance
- Executive Coaching – preparation and mentoring of Medical Directors and key leadership staff for successful MCO Management