NEWTON, Mass. - Last month McKesson Health Solutions released a national study finding value-based reimbursement has firmly taken hold but that payers and providers are struggling to operationalize some of the fastest growing payment models.
In response, McKesson Health Solutions announced Tuesday it has expanded its portfolio to include ClarityQx value-based payment technology through the acquisition of HealthQX. This technology enhances McKesson’s ability to help customers rapidly and cost-effectively transition to value-based care by automating and scaling complex payment models, such as retrospective and prospective bundled payment.
“The growth of bundled payment is something payers and providers can’t ignore, and we want to ensure our customers have all the tools they need to succeed,” stated Carolyn Wukitch, SVP McKesson Health Solutions. “These new value-based payment analytics, reconciliation and automation capabilities complement our value-based reimbursement suite, because they give our customers the capabilities to prepare for and scale bundled payment.”
Payers and providers are under immense pressure to operationalize bundled payments. Bundled payment is projected to be 17% of medical reimbursement by 2021, making it the fastest growing payment model. And the CMS is now mandating bundled payment in one out of every five metropolitan areas as part of its goal to make alternative payment 50% of reimbursement by 2018. Yet just half of payers and only 40% of providers are ready to implement bundles, and nearly 75% don’t have the tools they need to automate these complex models.
Now, with the addition of ClarityQx, McKesson can offer health plans a more complete portfolio that can automate their medical policy, payment policy, value-based reimbursement models, provider management and contract management.
Health plans use ClarityQx for analytics and for automation of retrospective bundled payment models and McKesson’s Episode Management to support automation of prospective bundled payment. Pairing ClarityQx with McKesson’s Episode Management gives health plans the ability to automate retrospective bundled payment processes today and move to prospective payment as they are ready.
In addition to ClarityQx, McKesson’s Network and Financial Management portfolio also includes McKesson Episode Management prospective bundled payment automation solution, McKesson ClaimsXten advanced claims auditing rules engine, McKesson Reimbursement Manager, McKesson Contract Manager, McKesson Provider Manager and McKesson Payer Connectivity Services.
ClarityQx was developed by HealthQX, a vendor of value-based payment analytic solutions for health plans and providers, which McKesson acquired in June.