Summary
As hospitals, physicians, and ACOs adapt to CMS’s evolving payment structures, the need for sustainable alignment models has never been greater. The Value-Based Enterprise (VBE) framework—introduced under recent Stark Law and Anti-Kickback exceptions—offers a flexible platform to integrate care, align incentives, and manage population health initiatives.
In this Team Connect webinar, presented by Pinnacle, experts Anthony Long and Jim Yanci break down the structure and potential of VBEs, exploring how organizations can leverage them to succeed under the CMS Transforming Episode Accountability Model (TEAM) and beyond.
Key Takeaways from the Conversation
- VBEs Defined: A CMS-recognized model that allows hospitals, physicians, ACOs, and even payers to collaborate under a shared governance and accountability structure.
- Alignment with Team: VBEs can house multiple population health activities for target populations and provide the governance, risk-sharing, and care coordination needed to thrive under mandatory programs like CMS’s Team model.
- Flexibility and Innovation: VBEs are intentionally broad, allowing organizations to define target populations, set risk-sharing thresholds, and pursue value-based activities without rigid federal prescriptions.
- Keys to Success: Physician engagement, reliable data, meaningful governance roles, and transparent communication are critical to effective implementation. VBEs succeed when designed for collaboration, not just compliance.
Traditional alignment models, from gain-sharing to co-management, often hit regulatory or structural barriers. VBEs move the conversation forward, creating space for innovation while maintaining compliance. By extending across acute, post-acute, and community care, VBEs provide the infrastructure to break down silos, coordinate across settings, and accelerate the shift from volume to value.
Is your organization preparing for the CMS Team initiative or exploring broader value-based strategies?
Pinnacle can help you design, implement, and optimize a VBE that drives both compliance and performance. https://askphc.com/services/strategy-operations-cost-reduction/
