Health systems are increasingly engaging in contractual arrangements in which they are responsible for the financial risk of a specific, targeted population. Often organizations do so without a full understanding of the competencies necessary to
achieve the performance objectives; as a result, they do not execute on critical clinical and operational capabilities necessary for success. Many health systems turn to primary care as a solution to manage populations and contracts; while work in primary care offers some solutions, there are many more operational capabilities that are required in a risk environment such as analytics, network management, utilization management, and other care and service capabilities. Implementing new capabilities that integrate with and inform the existing care model without fundamentally changing it will accelerate an organization’s ability to succeed under risk contracts.
Director and Practice Leader for Clinical Management, and Patient Engagement and Access
Melissa McCain is a Director with The Chartis Group, leading its Clinical Management, and Patient Engagement and Access practices. For more than 20 years, she has advised leading health systems and AMCs. She counsels ...