Financial Risk Management & Health Plan Operations
Conifer Financial Risk Management
Conifer Financial Risk Management helps you manage your risk-based contracts by providing the management infrastructure to be successful under new payment models. Our experienced healthcare managers carefully monitor revenue and accurately track and calculate expenses to monitor fiscal performance. This helps you identify and implement strategies to improve profitability. We provide clinical quality and financial reports to give you, and your board of managers and administrators, a clear, concise picture of clinical quality and financial status, including: clinical quality by physician; financial performance by contract; and risk-pool performance. We work with you to develop performance and strategic initiatives and we monitor their progress.
Key Benefits
- Manage risk-based contracts
- Identify and implement strategies to improve clinical quality and profitability
- Ensure the financial viability of your contracts
- Gain access to actionable financial and quality performance data
- Identify competitive, operational, and financial risks associated with patient populations
Full Management of Risk Contracts
Utilize expertise from 20-plus years of managing risk-based contracts for hospitals and physicians groups. A team of specialists monitor clinical quality and financial performance. It provides regular reporting to the group’s administration and/or board, while working with clinicians on improvement efforts in disease management, utilization management, and case management programs. These activities are essential for exceptional care of your patient populations.
Strategic Performance Review and Improvement
Our expert team will identify opportunities, such as Hierarchical Conditions Categories (HCC) or Risk Adjustment Factor (RAF) score improvements, and work with clinicians and administrators to implement improvement strategies.
Provider Alignment and Incentives
Helps create incentive structures for physicians and ancillary providers, and educate physicians and office staff on payment model and process improvement efforts. We embed physician leadership throughout the delivery system to mitigate risks and minimize waste in the care continuum.
Forecasting and Management of Risk Contracts
We model, forecast, and negotiate risk-based contracts, ensuring that payments align with the risk across the population.
Accounting and Financial Reporting/Analysis
We help you risk pool and turn data-including risk, cost, and utilization-into forecasting, trending and insights to make informed business decisions.
“We knew the sooner we had a platform in place to help guide us in managing the population, the sooner we could achieve the goals of our value-based contracts”
Brian Christoper,
Vice President of Administration,
KentuckyOne Health Partners