Strategic Options for a PHO
Client profile: PHO associated with a major New England tertiary care teaching hospital
Project type: Strategic and business planning
Challenge: Help the PHO reach a new market by bringing its varied constituents (employed faculty, community physicians, hospital management) together around offerings that would be attractive to the community’s several large self-insured employers.
DGA Solution and Results: DGA facilitated a strategic planning process culminating in facilitation of a retreat. We presented options and analysis to support decision-making. The PHO’s multiple constituents were emboldened to contract directly with self-insured employers using pay-for-performance contracts. This innovative strategy offers these employers value through a coordinated healthcare delivery system. The PHO, by becoming a preferred option for large employers, established a strong market position.
Increasing PHO Revenues
with Clinical Integration and Expanded
Pay-for-Performance
Client Profile: PHO associated with a tertiary teaching hospital
Project Type: Strategic and business planning
Challenge: To help a successful PHO adjust to changes in regulations and market conditions by adopting clinical integration and expanding pay-for- performance.
DGA Solutions and Results: DGA led strategic planning processes developing new strategies to replace the original contracting focus of the organization. The new strategies included an extensive clinical integration effort and significantly expanded pay-for-performance based on evidence-based clinical protocols and other quality initiatives. DGA also assisted the PHO to enhance its disease management program and develop an electronic medical record strategy.
The new strategies provide value to large payers in addition to the smaller payers that had previously been served by the PHO. This new client base significantly increased PHO revenue based on the true value of the services it was in a unique position to provide.
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