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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

Available now

Jamie L. Reedy, MD, MPH
Chief Population Health Officer, Summit CityMD
Ashish D. Parikh, MD
SVP of Medical Affairs & Quality, Summit CityMD