Sellers Dorsey defines value and quality as the solution for public payers and healthcare providers to manage rising healthcare costs while ensuring that the best level of care is being provided to the consumer.
In today's market, payers will be looking to invest in delivery systems that promote quality, consumer health and personal engagement. Financial and programmatic incentives should align with and reinforce desired provider and consumer behaviors.
As partners, providers of public healthcare can become more effective advocates for the systems they design and implement in the interests of assisting public payers in the delivery of the best value and the best quality of service.
At Sellers Dorsey, we have experience developing innovative and practical solutions that can assist public payers and providers in improving their programs and services, and achieving impactful goals. Our ideas begin with one premise in mind: Payers can achieve higher value in service when there is a measurable delivery of higher quality of service from providers.
Some of the solutions that we have found to be effective include:
Assuring value from managed care
- Aligning MCO pay for performance to focus on improving health status
- Promoting alignment of providers, consumers and MCOs
Assuring value from fee for service programs
- Developing stronger contracting provisions and performance metrics for PCCM and Disease Management programs
- Instituting Disease Management as part of EPCCM programs
Improving quality of hospital services
- Defining and measuring pay-for-performance metrics
- Designing and implementing hospital payments systems
- - Strengthening incentives for appropriate hospital care in FFS and HMO systems
Creating value from other service providers
- Implementing selective contracting initiatives among provider types that leverage Medicaid buying power
- Creating reimbursement programs that directly relate reimbursement increases to performance and quality
Of course, we know there are many more ideas and options for improving the value and quality of our nation's healthcare. And, we want to work with you to identify them, build a plan to create them, and assist you through their implementation.