Emerging Payment Models

Emerging Payments: The Total Cost of Care Model

Key stakeholders within the healthcare sector are investing significant efforts towards achieving the Triple Aim: improving patient outcomes, enhancing the patient experience, and reducing per capita costs.

To this end, stakeholders have been adopting alternative payment models that incentivize improved health outcomes. These payment models distribute risk across stakeholders – including providers, consumers, and employers – who each take on greater responsibility and risk in regards to both cost and quality. Noteworthy payment models include shared risk, shared savings, pay for performance, and bundled payments.

The Kinetix Group’s new white paper, published in collaboration with eyeforpharma, discusses the impact of emerging payment models, including the investment in data management capabilities, transformation of systems of care, and increase in provider accountability, with real world case studies from key industry players such as Remedy Partners, UnitedHealthcare, Horizon Blue Cross Blue Shield of New Jersey, and more.

Furthermore, the paper provides insights into the short and long term solutions that can be provided by the pharmaceutical industry, as the traditional pharmaceutical “reach and frequency” model remains effective only in select fee for service markets, but has limited applicability in value-based settings.

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