Sonny

Risk-based Contracting for Value-based Care, a Founder's Playbook

Julie, Justin, Jack Stoddard, Rajay Bhatniji, Corbin Petro, Faye Rottenberg, Satish Jain, Mike Copco, Sunny Goyal, Sonny

This event analyzes the strategic transition from fee-for-service to value-based care models as a solution to unsustainable healthcare costs and the need for system resiliency. Industry leaders from organizations including Patina, Waymark, and Blue Cross Blue Shield of NC discuss the risk spectrum ranging from pay-for-performance to global capitation, emphasizing that success requires tailored glide paths, early partner alignment, and robust upstream metrics. The presentation outlines critical investment criteria for scaling risk-based contracts, including the necessity for specialized actuarial talent, sufficient capital reserves for statutory requirements, and clear roadmaps for managing total cost of care alongside clinical outcomes.