HCM 4025 Assignment Risk-Based Reimbursement

In this year’s Modern Healthcare Hospital Systems Survey, only nine out of 60 respondents said they derived 10% or more of their net patient revenue in 2016 from risk-based contracts, which was largely in line with last year’s survey. Three-quarters of the respondents estimated that risk-based contracts generated 4% or less of their net patient revenue, but most indicated their share of risk-based contracts would slightly increase in 2017.

HCM 4025 Assignment Risk-Based Reimbursement

Notably, 19 respondents said they recorded a surplus on risk-based contracts. At Montefiore Health System, 22% of net patient revenue was tied to risk-based contracts, ranking the system seventh on that measure in Modern Healthcare’s survey. The New York City-based health system has been moving toward risk-based contracting since 1996, said Stephen Rosenthal, senior vice president of population health management.

“We have made an enormous investment in our infrastructure with almost 1,000 full-time employees managing 400,000 individuals” covered by risk-based contracts, Rosenthal said, adding that about 235,000 patients receive care under full capitation. “They are coordinating care and helping manage people’s health. It’s an investment many organizations today find difficult because they don’t have the opportunity to support infrastructure through risk arrangements. You have to start small and grow over time.”

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