Blog: Top 5 Reasons Operating Partners are Critical in the Transformation to Value-Based Care

Healthcare organizations venturing into value-based care are operating in a time when success is defined by an increasingly broad set of outcome metrics around quality, cost, patient satisfaction and provider engagement. Meeting these metrics requires a complex combination of expertise, process, cultural change and the adoption of innovative technologies – all of which need to be architected and tuned for local market conditions.

For those embarking on this journey with mission-critical strategies and career-defining decisions, alignment with an operating partner brings risk mitigation and accelerated time to market. The recipe for transformation is not a one-size-fits-all approach nor a simple aggregation of various niche solutions. Rather, CEOs on the hook for success need a unified approach and a holistic solution to cost, quality and patient satisfaction.

KLAS recently released a report naming Lumeris the top-rated value-based care managed services provider in the area of client-reported impact on the Triple Aim. Lumeris is pleased to see the market category of value-based care managed services mature and agrees with the view that this space entails an end-to-end solution to manage the transformation to and the ongoing support of value-based care.

KLAS’ coverage and investor interest in this market highlights the major role that managed services providers, or operating partners (as Lumeris calls itself), play in helping healthcare organizations grapple with meeting the generational challenge we face around rising healthcare costs.

Here are the five reasons operating partners are critical for the transformation to value-based care:

1. They enable providers to be all-payer and all-population capable:

The heart of the transformation from volume- to value-based care lies in how physicians deliver care to their patients and the populations they serve. Lumeris’ Triple Aim Plus One solution highlights physician engagement and satisfaction as a critical component to drive change in value-based care. My colleague Carol Murdock, senior vice president and head of market at Lumeris, explains that incentivizing physicians is key to driving change in physician behavior in her recent blog post. Increased physician engagement supports overall job satisfaction, resulting in better patient communication and outcomes.

In addition, physicians cannot constantly adapt their practice based on the nuances of the payer contract terms or payer provided software solutions. Successful approaches must be multi-payer, multi-population by design and single-payer solutions will ultimately be ineffective for physicians and unable to scale. Physician engagement is a core part of the Lumeris approach, as our research on the Accountable Primary Care Model articulated.

2. They bring agility and speed:

Niche solutions are difficult to assemble, frequently don’t interoperate well and can be ineffective when swift solutions are required in the transformation to value-based care. Deploying a niche solution for every problem creates complexity and sub-additive results.

Speed to market comes best from a “managed services general contractor” approach to design, build and operate solutions that fit your organization. This not only eliminates component shopping and high assembly costs, but brings the simplicity of having one relationship with an operating partner who leverages proven expertise, processes and technology to make agility possible and strategic pivots (if needed) easier.

3. They go beyond consulting to drive execution and activation: Value-based care has been a boon to the consulting industry. Like many have joked, accountable care organizations (ACOs) have been equivalent to an Amazing Consulting Opportunity. But operating partnerships go beyond strategic analysis and planning. They place an emphasis on “the how” and then work shoulder-to-shoulder to realize the business case. At Lumeris, our DNA is made of equal parts practitioner and equal parts solution provider. This hands-on experience as operators helps us integrate rapidly and effectively to the cultures of our clients.

4. They inject hard to source talent and expertise: Finding the right expertise in the right capacity is a major barrier to organizations looking to achieve scale. Operating partners are able to inject resources, armed with proven methods to accelerate the activation process. In some scenarios, this may be to fill short-term gaps and in others it may be a long-term outsourcing role to help the healthcare organization focus on their core competencies. In both cases, mobilizing the right capacity of people talent is a major competitive advantage.

5. They mitigate risk with aligned incentives and true accountability: The core of operating partnerships are designed around value creation. This value creation is defined around clear metrics and grounded in strategic analysis and roadmap planning. Hence, compensation is aligned around the achievement of those goals where both parties win (or lose) together. Clearly communicating the goals and measurement of these outcomes establishes accountability for both parties. The overall goal of the partnership is to completely transform the income statement and share in the value, rather than be a tax to the business.

If you are interested in moving from volume- to value-based care with a proven operating partner, contact us today at (314) 209-2702 for more information about how Lumeris’ collaborative approach can transform your organization.