Value-Based Care and Reimbursement

  • Max Reiboldt, CPA

    Max Reiboldt, CPA



The challenges of moving from volume-to-value payments are significant and require careful planning by healthcare leaders in all types of organizations. Whether you’re a large healthcare system wondering whether you should enter into an at-risk population health management contract, a hospital considering how you will operate successfully under a bundled payment model for orthopedic or cardiac surgery, or a physician practice questioning how you will fare under MACRA/MIPS, these issues are critical decisions that must occur.

Value-based care delivery calls for new cross-enterprise capabilities that include clinical, administrative, and financial components. These capabilities require new tools and functions for appropriate management of:

  • Care delivery performance
  • Post-acute care strategy
  • Large patient populations
  • Multiple contracts
  • Physician distributions
  • Effective usage of technology
  • Regulatory compliance

At Coker, we offer a suite of advisory and technology-related services to help organizations make these decisions and provide a smooth transition to ensure success in the future.

Specifically, we help operationalize the following clinical and administrative processes:

  • Clinical care
  • Network integration
  • Revenue enhancement
  • Risk stratification
  • Beneficiary tracking

We have a trademarked approach that we refer to as our Coker ValuePath™ services. Coker ValuePath™ services utilize proprietary data insights to improve care processes, which increases quality scores, lowers patient cost, and captures risk-adjusted coding improvements necessary to succeed with value-based reimbursement contracts.

Our perspective categorizes solutions within three pillars:

  • Alignment models
  • Care Process Design System
  • Financial strategy

Value is at the nexus of these three pillars, which we define simply as quality-per-unit-of-cost.

Within these pillars are an array of services we leverage to help organizations identify and achieve desired outcomes. From aligning with partners through various forms of network development to forecasting financial return associated with changing regulations and evolving payer contracts to improving the clinical workflow through best practice insights, we can help your organization achieve whatever value-based initiative you encounter.

Questions? Ask an expert!

    Contact us today for more information about our healthcare consulting services and learn how we can help your organization.

    Contact Us