Carol Opportunity Assessment

Foundation of Care and Payment Redesign Strategies

Carol Corp. believes meeting the twin challenges of increased access to care and the relentless pressure to reduce costs requires a fundamental change in the financing and delivery of health care. Carol supports a shift from the status quo system that rewards volume to a system that rewards high-value accountable care. Carol provides the detailed roadmap and implementation strategies to successfully make the shift to accountable care by aligning the staged implementation of care redesign to the evolving financial model that optimizes revenue management.

Opportunity Assessment – General Overview

Carol's experience has shown that each organization's journey from volume to value is unique, and Carol believes the Opportunity Assessment of an organization's cultural, competitive, fiscal and clinical environments should be the first step on the journey toward accountable care. The Opportunity Assessment is a data-driven, comprehensive review of an organization's ability to profitably deliver high-value accountable care.

Through this dynamic process Carol identifies quality and efficiency opportunities that will drive the care redesign process and ultimately help frame payer negotiations and strategies. The Opportunity Assessment consists of qualitative and quantitative components, and the synthesis of this process is the Carol Index™. The Carol Index is a proprietary measure of an organization's potential to successfully deliver accountable care. It is a valuable tool that helps prioritize the actions and investments for an organization to consider as they begin their journey to accountable care.

Qualitative and Quantitative Assessments

Through an extensive interview process of key leaders and major stakeholders, the qualitative component of the Opportunity Assessment examines the structure, culture, market dynamics and capabilities of an organization to assume clinical performance risk. The quantitative assessment integrates payer and provider data, helping to identify actionable items with the capability to drive greater efficiency and clinical quality. These items are then measured against a customized component to ensure that the identified opportunities are actionable within the context of the provider's culture and capacities. Actionable activities are then organized into solution sets each with clinical, operational and financial components.

Carol Index™

The synthesis of the quantitative and qualitative assessments is an iterative process that is completed within the unique context of each organization's clinical quality, operational, financial and strategic considerations. The conclusion of the Opportunity Assessment is the Carol Index, a proprietary measure of readiness to begin a successful journey to accountable care. The Carol Index summarizes the findings from the quantitative and qualitative assessments into solutions sets, which represent measurable cost savings and quality improvements.

The Opportunity Assessment process is a robust and disciplined analysis of an organization's ability to be rewarded for delivering high-value accountable care.

Carol Opportunity Assessment: High-Level Overview