Trusted Healthcare Advisors

"Value based care? When technology delivers actionable analytics into the hands of clinicians and decision makers, only then will we drive operational efficiencies, improved quality, revenue optimization, and truly transform healthcare." - Colleen Greene, CEO & President at Allegro Healthcare

"Value based care? When technology delivers actionable analytics into the hands of clinicians and decision makers, only then will we drive operational efficiencies, improved quality, revenue optimization, and truly transform healthcare."- Colleen Greene, CEO & President at Allegro Healthcare

With the increasing pressure from the federal government and commercial employer groups to transition away from a fee-for-service model (paying for quantity) and shift the focus of the American healthcare system to lowering costs of care, improving health outcomes, and increasing access to care, payers and managed care organizations (MCOs) are transitioning to a value-based reimbursement model. The shift toward increased payer-provider collaboration, outcomes-based payment, and new benefit design is driving how payers and MCOs pay for healthcare and that affects how healthcare is delivered. Payers have started by shifting the primary care providers to alternative payment models, such as value-based contracting arrangements and holding providers accountable for all the patient healthcare costs (specialty visits, ER, inpatient, etc.). Some payers are even extending this to specialty care, outpatient care, and hospital inpatient contracting arrangements.


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What's in it for providers?

  • Capitalize on the revenue opportunities and alternative payment models

  • Additional payments for the extra care coordination services

  • Additional payments for the complexity of the patient population you service

  • Improvement in your quality measures

  • More attention from MCOs/payers

  • Less pressure to increase daily patient volume in order to receive more revenue

What's in it for the payers?

  • Improved HEDIS metrics

  • Avoid penalties for at risk HEDIS measures

  • Improved Risk Adjustment, resulting in higher "premium gains" 

  • Lessen the burden for health plan staff (care coordinators, provider reps, etc.)

  • Stronger relationships with your valued provider partnerships

  • Aids health plans in meeting their MLR targets, cost savings, resulting in a decrease in over-utilization of emergency room, inpatient, testing for radiology, lab and other services based on providers managing the patient's healthcare cost utilization


How we help

Whether your organization is on the provider or payer side of value-based care, let Allegro Healthcare help you capitalize on new revenue opportunities and improve health outcomes for your patients/members. Our team leverages deep knowledge in provider-payer contracting, value-based contracting, risk-based modeling, successful implementation of clinical cost savings and quality improvement programs, clinical informatics, medical economics, technology, and IT in order to help providers and payers win at value-based contracting, as well as improving population health, bending the healthcare cost trend, and improving the patient experience.

Find out more how we can put our insights to work for you:

  • Transition to value-based reimbursement contracting & capitalize on new revenue models
  • Technology strategy & data sharing
  • Population health & HEDIS/quality care gap closure
  • Payer-provider contracting & payer-provider collaboration
  • Analytics, business intelligence, and data visualization
  • Digital transformation & systems integration
  • Interoperability & performance improvement