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New, free course on capturing the value of V1C for healthcare!

Join FDA and DiMe during a 2-day virtual event.

Core Competency:
Administrative Efficiency

Use this core competency to learn the importance of streamlined execution and clinical rigor in distinguishing top companies. This will enable you to attract talent, maintain quality, and foster partnerships.

V1C providers will learn to set up platforms to streamline critical activities and promote administrative efficiency for potential partners.

Value proposition

V1C is a rapidly expanding field crowded with innovative first-to-market and fast-follower solutions. The ability to execute efficiently, consistently, and with clinical rigor distinguishes the top companies from those that will not scale beyond an initial niche market.

Outstanding V1C entities are adept at balancing innovation and rapid cycle improvement with clinical and professional rigor, enabling them to attract and retain top clinical workforce talent, manage market-leading quality, access, and patient satisfaction targets, and adopt a flexible approach to partnering with health plans, providers, and employers.

Considerations

Third-party payor deals and reimbursement are becoming critical to establishing V1C as a new standard of care accessible at scale and a natural progression for V1C solutions that may have started in the direct-to-consumer market.

Positioning for third-party payor contracts requires a clear understanding of the alignment between the payor’s systems and processes around new care modalities. Contract discussions must start with a shared definition of V1C solutions as healthcare providers with the same obligations to patients as brick-and-mortar providers.

Success indicators
  • There are established pathways for reimbursement beyond patient self-pay, including claim submission processes for working with payors or entering value-based arrangements.

  • Safe and effective patient acquisition practices to ethically market services and implement proven methods for identifying, reaching, and enrolling eligible participants.

  • There are scalable onboarding and management protocols for quick and efficient implementation.

  • Relevant quality and performance management standards and metrics are clearly defined to ensure adherence to clinical guidelines and safety protocols, with the ability to provide real-time feedback to clinical care teams.

Stakeholder perspectives on administrative efficiency

  • Patients perceive efficiency as the ease of completing administrative tasks, receiving support, scheduling options, and outstanding payment experiences.

  • Providers prefer workflows that free them from administrative burdens and enable them to practice patient care at the top of their license. Value-added operations include assisting with credentialing, licensing, and training, as well as flexible work schedules.

  • Payors and employers value V1C partners who clearly understand how their solution fits into their existing offerings while bringing a flexible and collaborative approach to contracting, implementation, and performance improvement.

  • Investors prioritize efficient and compliant operating models to ensure that a venture can scale and continue to improve cost structure with scale without compromising patient experience, quality, and access.

What does high quality, trustworthy V1C look like? Explore the Core Competencies framework to discover what good V1C looks like and how to get there.

Effectiveness

Produce outcomes that are valuable to your key stakeholders

Trustworthy digital experience

Deliver an ethical, equitable, and safe digital experience

Clinical & operational integration

Fit seamlessly within a broader healthcare context

Administrative efficiency

Minimize implementation and operational frictions

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