Value Based Reimbursement (VBR)
Get the insights you need to achieve maximum financial results from your Value Based Reimbursement programs.
The accelerating march to value- and outcomes- based reimbursement models is bringing unprecedented challenges to healthcare providers of all kinds. As a leader of an organization entering into risk based contracts, you are faced with the monumental task of transforming your organization’s entire operational system to function and thrive in a new and constantly changing world order.
However, within the uncertainty lies great opportunity. Healthcare reimbursement models have never before been so closely aligned with your core mission of providing high quality care. And that alignment will only get stronger with time.
At Zirmed, we believe strongly that a successful healthcare business results in healthier patients. Our Value Based Reimbursement (VBR) solutions are designed to provide the advice, data and processes necessary to enable you maximize your reimbursement in a sustainable and predictable way. With one less thing to worry about, your providers can focus on what they do best – delivering high quality, patient centered care leading to better outcomes for all.
We understand that organizations are at different stages in the transition to risk. Which is why we also provide MIPS Quality tools to help maximize your Medicare reimbursements under MACRA while preparing to take on more risk. Our comprehensive MIPS Quality Toolkit is designed to help you successfully meet MIPS Quality reporting requirements. The Toolkit includes:
- MIPS Quality Suggested Measures Report—analyzes up to your last 12 months of claims to quickly and easily determine which current measures are most applicable to your organization.
- MIPS Quality Monitoring Service—screens all outgoing Medicare Part B claims for errors and omissions, making it easy to find and correct claims that lack the necessary data while minimizing workflow disruptions.
Delivering actionable insights to every level of your organization
To optimize your performance under value-based reimbursement models, stakeholders at every level of your organization—from physicians, specialists, and care coordinators to managers and administrators—need clear, actionable insights delivered at the right time.
ZirMed’s sophisticated Value Based Reimbursement analytics dives deeply into the mountains of raw data that’s already available about your patients’ health and clinical history. We enrich your data with our own proprietary algorithms, and we do the heavy lifting to ensure comprehensive longitudinal records of care, identify gaps in care and group patients into accurate risk cohort groups.
Then we deliver precisely the information clinicians and administrators need to make smart, real-time decisions about patient care and expenditures.
Maximizing Your Value Based Reimbursement Potential
At Zirmed we don’t just throw technology at you – our team of experts work with you to help you:
- Understand your organization’s current performance as well as your unique strengths and weaknesses so that you can effectively prioritize programs that can have the most impact
- Understand what success means to your organization and what the journey looks like to get there
- Set meaningful, objective and achievable goals for all your value based programs based on your unique circumstances and capabilities
- Engage all stakeholders and create a culture of improvement by providing accurate and timely data on which they can take meaningful action thereby maximizing revenue, reducing care variation and improving patient outcomes
- Set up systems and processes that enable you reach your maximum reimbursement potential in a predictable and sustainable manner
Get relevant and timely information that keeps your clinical staff ahead of the curve. You’ll benefit from:
- A complete data picture of each patient using patient data aggregated from across the care spectrum to provide sophisticated insights at the enterprise, provider and patient level.
- Care Gaps reports pulling from disparate sources to identify any gaps that may not be reflected in the medical record and that tie back to relevant quality measures Intuitive Care Coordination workflows to optimize your resources and get the most out of your care coordination programs.
- Point of Care Reports for physicians to track gaps in medical history and take necessary action for patients
Physician Cost and Utilization
Whether you need to manage and better understand high-cost cases or ensure clinical best practices across your entire organization, ZirMed gives you the insight you need to accomplish your goals. You will receive:
- Cost analyses for insights into efficiency trends and variations at both a macro/enterprise level as well as a micro level. We highlight opportunities by episodes of care, care settings, providers, patients etc. so that you understand the risk and return drivers at all levels
- Utilization analyses to identify and prioritize opportunities for improvement and benchmark provider performance to highlight outliers
- HCC risk score management to ensure budget accuracy and set you up for successful reporting
- Provider performance scorecards to highlight opportunities for engaging your providers and aligning them to your business objectives
Risk Management Analytics
To create programs that have the most impact, you need to understand your patients’ risk factors so that you can intervene early when it matters most. We provide:
- Predictive Patient Risk Stratification using industry-standard population analysis tools to identify highest risk and highest cost patient cohort opportunities for care coordination intervention
- Identification of the the underlying illness burden and calculation of population risk scores so you can understand your patient population risk profiles
Interoperable cloud-based solutions for every major value-based care program
Unlike population health products from EHR vendors, ZirMed’s Value Based Reimbursement solutions are fully vendor-agnostic and interoperate freely with all of your other systems. And we offer solutions for all major value-based care programs, including:
- MSSP (Shared Savings, Shared Losses, HCC, Leakage)
- Medicare Advantage Stars Program (MA Stars)
- Commercial ACO/P4P
- MIPS Quality
- Comprehensive Primary Care Initiative (CPCI)
- Patient Engagement & Case Management
- California IHA P4P
- And more
Ready to learn more?