Page 116 - CHHA Binder 2.3.20

4/11/2019

Value-Based Healthcare at VNSNY- Case Rate

Applicable to patients under specific Managed Care plans and
products

Patients managed for 60 days
Plan and provider negotiate episodic rate based on past
utilization

Providers receive a fixed rate to manage episode and retain
savings (if actual < episodic rate) or incur loss (if actual >
episodic rate)

Strengthen partnerships with other insurance plans

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What benefit does Case Rate have for us?

VNSNY Patients

 Opportunity to earn greater revenue if  Reduces disruptions by
Quality goals are met AND utilization streamlining the authorization
is managed appropriately process
 Helps offset reimbursement  Develops a coordinated team
reductions approach

 Enables Managed Care to be more  Provides support and better care
profitable over entire payment episode
 Makes VNSNY an industry leader in  Focuses care on helping patients
Case Rates get better and remain out of the
hospital

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