Source: The National Business Research Company, 2023.
*includes pay-for-performance or quality to full capitation.
Source: Dodge Data and Analytics; PitchBook; McKinsey analysis
Enables nephrologists to succeed in CMS and MA VBCs focused on reducing CKD/ESRD costs
Enables oncologists to prescribe an appropriate drug for the patient while maximizing practice margin from prescription
Large spend area with significant employer focus and increase in penetration of episodes
Pregnancy episodes particularly in Medicaid and increasingly commercial
Large spend area, particu- larly in MA, driving high inpatient and emergency department utilization; site-of-care shift for pro-cedures
Episode-based models for facilities with more innovative approaches involving PCPs on integration of BH/physical health
Enables nephrologists to succeed in CMS and MA VBCs focused on reducing CKD/ESRD costs
Enables oncologists to prescribe an appropriate drug for the patient while maximizing practice margin from prescription
Large spend area with significant employer focus and increase in penetration of episodes
Pregnancy episodes particularly in Medicaid and increasingly commercial
Large spend area, particu- larly in MA, driving high inpatient and emergency department utilization; site-of-care shift for pro-cedures
Episode-based models for facilities with more innovative approaches involving PCPs on integration of BH/physical health
Primary care first, MSSP,² ACO REACH³
Kidney care choices, ESRD treat- ment choices
Oncology care model, enhancing oncology model
Comprehen-sive care for joint replacement, BPCI²
n/a
BPCI
n/a
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