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Value-based care and commercial risk: Making a successful start

Healthcare Analytics Population Health Management Risk Management Value-Based Care

What are the critical steps for tackling commercial risk in value-based care?

Summit CityMD is a physician-led, physician-owned, multi-state organization with 1,300+ providers, $1.16 billion in revenue and 7+ years of experience in commercial risk. Their 190+ locations include a comprehensive cancer center, high-acuity urgent care centers, and ambulatory surgery centers in the New Jersey-New York area.

When Summit initially dipped their toes into commercial risk-based contracting, they quickly recognized that the strategies that worked for Medicare or Medicaid value-based programs fell short in the commercial space.

As a pioneer in their approach to managing risk and commercial contracts, Summit leadership shares how they collaborated with health plans to develop a risk-based payment model appropriate to their medical group’s capabilities, effectively negotiated contract terms, and built a clinical, operational, and information technology infrastructure that allowed them to succeed.

Summit explains:

  • Why commercial risk is different than Medicare and Medicaid
  • What are the keys to negotiating with a payer
  • How they developed clinical, operational, and technical strategies to succeed
  • Why it is vital to use data effectively to drive performance
Jamie L. Reedy, MD, MPH
Chief Population Health Officer, Summit CityMD
Ashish D. Parikh, MD
SVP of Medical Affairs & Quality, Summit CityMD