January 5, 2018

Value Service Organization

What is a "VSO"?

It is a new type of managed services organization focused on developing high performing physician networks that maximize revenue for existing fee for service (FFS) and new “value” contracts.

Value contracts are those that share or manage both risk and quality. The VSO enables its participating providers to succeed within new revenue streams by providing the core capabilities necessary for their success.  Our VSOs are locally owned and led by provider entrepreneurs that have deep relations within the provider network and the community it serves.

CURA  delivers a comprehensive franchise model of customized services required to meet the unique and localized market needs of the VSO.

Entity Formation & Ownership Structure

CURA brings the expertise to develop the Value Service Organization and associated Provider organization legal structure and ownership structure. Designing the right equity and funding partnerships are a key component in building a successful organization structure.  In addition, CURA brings the right players to the table so that alignment amongst stakeholders is present.

Contract Compliance

Every payor contract as well as every legal entity brings compliance requirements and issues.  CURA takes the burden of managing these off the plate of the VSO.  We bring standard policies and procedures as well as customize as needed.

Network Development

Developing a high performing network for a Value Service Organization is very strategic.  CURA will develop a progression strategy toward risk and alternative payment contracting with Payors.  Based on this strategy and using a proprietary data set, they identify the right doctors in the local market to recruit.  CURA manages the recruitment and contract effort on behalf of the VSO.  Also developing the right contracting strategy by provider type creates the necessary physician alignment and engagement post recruitment.

Clinical Integration

The key difference between prior failed managed care models and the new value based models emerging is the ability to integrate and report on clinical data.  Providing clinical and claims data to Providers at the time of care is key to succeeding within value based care models.  These new models are outcome driven and rely on clinical transparency between treating Physicians.  CURA brings population health insight and clinical data connectivity to the VSO for ultimate success.  This includes EMR/HIE integration, access to medication, lab and real-time eligibility data to name a few.

Payor Contracting

Value Based, Risk, Performance Network, Narrow Network, Bundled Payments and Gainsharing.  These are all the buzzwords in today’s provider contracting narrative.  It is crucial that the provider know how the payer economics intersect with the provider’s role within the total cost of care environment.  Too often we see providers that have performed well beyond their peers but are not compensated appropriately or they have been put at significant financial risk.

We balance the fact that the payer has a team of lawyers, actuaries, and claims payment experts.  They negotiate hundreds if not thousands of these contracts and at best the provider negotiates a dozen.  They have had all the data but CURA now levels that playing field.  Not only do we know where every PCP ranks in their local geography, we know how each geography compares to the next.  We also know how each provider performs relative to their neighbors and competitors.

In value based payment model bending the cost curve is the goal.  CURA makes sure that contracts are negotiated from a position of strength that rewards providers for success.