Value based pricing
Value based contracting; strategies for success.
Most of my funding comes from government (but I assume the question is just as applicable to funding from insurance providers and any other large, powerful source). We will never be the cheapest because we of our values (quality comes at a price) but we do deliver better outcomes – yet those reviewing tenders appear to award higher points to price.
I am interested in knowing if anyone has any strategies or tactics to convince funders to award contracts based on value rather than price?
Participant comments on Value based pricing
Actually the quality comes at a price seems to be a heavy sentence to be heard by the payers, however you might use the sentence “quality comes at a the right price” which might be easier for the airs of the funders. In general never say that your price is high ! it always depends, if you can prof that the overall payments of the funders or insurances are less “as overall” by providing better care then you will have a strong case to convince the payers.
I think that there is a total cost-of-care argument to make to the payer(s). If your outcomes are better you should see lower readmission and complication rates. I would show this information to the payers.
All complications carry added expense. Wound infections may cause readmission with need for reoperation. At a minimum outpatient antibiotics carry a cost. The same is true for readmission following medical or surgical procedures.
If your quality data shows low readmission, infection, return to the ED, etc, you should be able to make the point that you are saving the healthplan money post discharge even if the initial admission is somewhat more expensive.
You think you have better outcomes but you have to prove that with robust data (many different indicators) to convince the government that in the end if they contract your organization they will actually save money since you give them better outcomes and less complication rates, for example. Data is crucial for decision-making and proof of concept otherwise things remain too abstract.