The Leavitt / FHG Advantage

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The Leavitt Partners and Forward Health Group CPC+ Collaborative creates a unique value proposition for payers and providers – it’s a coming together of expertise, data, and technology that creates real solutions for all stakeholders. Learn more about Leavitt Partners here.

 Four things you need to know about CPC+:

  • CPC+ is CMS’ largest-ever initiative to transform and improve how primary care is delivered and paid for.
  • CPC+ has a unique hybrid payment structure where there’s upfront funding with additional Track 2 monthly care management fees.
  • CPC+’s hybrid payment design allows for innovation in practice redesign by providing physicians with the flexibility to deliver care outside traditional face-to-face encounters.
  • CPC+ provides a path for primary care physicians to qualify as an Advanced Alternative Payment Model (APM) through the proposed Quality Payment Program under MACRA.

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The goal of the Leavitt Partners / Forward Health Group Collaborative is to be your single-point gateway to success with CPC Plus. Depending on your needs and readiness, we offer turn-key as well as subscription-based products and services across competencies as well as continuum of care. Key areas include:

Strategy

The basic foundation of CPC+ is to redesign delivery as well as aligning payment. This requires significant collaboration between payers and providers in the regions, and significant interaction with CMS. Success depends on leveraging the flexibility accorded to the physician in forming relationships with specialists as well as health plans to choose an optimal path to improving quality of care while reducing costs. Our Collaborative has extensive expertise in setting up alternative payment models and merit-based payment models. If you are in any value-based purchasing contracts currently, then inviting your existing payers to come to an understanding on common measures and goals will significantly reduce the burden of keeping track of different guidelines, metrics, and payment schedules. We excel in creating management frameworks required for success, negotiation of commercial terms, as well bringing all the required stakeholders together to achieve community-wide success. Our knowledge of the inner workings of CMS and federal government health care helps remove roadblocks, reduces risk and uncertainty.

Finance

Leavitt Partners and Forward Health Group have been spearheading the transition to value-based care. Having successfully set up finance models for ACOs and many leading health care entities, we have developed mature processes and proven tools to assess the financial path that is right for you. With options for APM bonus for MACRA, impact on MSSP and MIPS, getting the financial structure to drive the strategy is key to becoming financially sustainable from the get-go. CPC+’s payment calculations are not simple. We bring you the expertise to get the financial model right, to the last excruciating detail.

Clinical Operations

With more than 50% of the CPC+ drivers focusing on complex care management, it is critical to have a core clinical strategy that not only compliments the financial strategy, but also integrates with care providers across the continuum including behavior health specialists. Our team has extensive expertise in not only implementing but running the key components of CPC +, e.g. care management, patient engagement & experience, utilization management, and population health management. The significant shift of the traditional payor-based utilization management and complex case management to the provider side is evident. While concepts may be similar the implementation of processes and tools are complex and should be specifically tailored to your population, competency and your existing tools. The Leavitt/Forward Health Group partnership has proven expertise in improving quality of care, reducing ED visits, reducing readmissions an other cost drivers using URAC-certified UM, CM, and DM processes. Our expertise interacting with CMS on these issues, and experiences from past CPC initiatives, provides you with an added safety net.

Administration

Administration of CPC Plus is designed to not be cumbersome. While the end process of receiving reimbursements is simplified, the complexity of internal administration and cost tracking is more complex. This is also an area where the physicians can heavily rely on result-based external entities to simplify administration and reduce cost. Leavitt and Forward Health Group provide an administration simplification strategy and execution plan to stakeholders across the health care continuum.

Data and technology

Success in Track 2, relies heavily on leveraging your data sources including EHR/EMR. Forward Health Group’s top-rated in KLAS-proven population health management and data management suite of products are ideally suited to get you up and running by January 1 2017 with minimal additional upfront investment. Further, we work with you to leverage your existing assets, help you execute the customization and workflow configurations needed to deliver complex coordinated care…all founded on bringing you clean, accurate data irrespective of the number of quality of the data sources. We will also help you leverage public sources (e.g., CPC+ Practice Portal, CPC Connect and CPC learning communities).


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