Jackie Selby Quoted in “Key Capabilities for Population-Based Alternative Payment Models”

RevCycle Intelligence

Jackie Selby, a Member of the Firm in the Health Care and Life Sciences practice, in the firm’s New York office, was quoted in RevCycle Intelligence, in “Key Capabilities for Population-Based Alternative Payment Models,” by Jacqueline Belliveau.

Following is an excerpt:

To succeed in population-based alternative payment models with two-sided financial risk, health systems should embrace assuming the role of the payer and work to get all staff on board with the model, suggested Jackie Selby, a healthcare and life sciences member at the consulting firm Epstein Becker & Green, PC. …

With industry-wide pressure, more health systems are turning to population-based alternative payment models. Selby advised these systems to address key components of population-based risk structures that payers traditionally managed, including population size, provider networks, data analytics, and utilization management. …

“Normally the health plan, without sharing risk with the hospital system, would be providing their members with the network,” Selby said. “This is managed care. It would be a PPO or an HMO-type product and there might be a gatekeeper, like a primary care doctor, from who you have to get a referral.”