Is New Wisconsin Family Care IRIS 2.0 Value Based???

WISCONSIN FAMILY CARE IRIS 2.0 COST IMPACT

With the New Family Care IRIS 2.0 the value being paid for is an increased ability to anticipate and respond to needs.  Public Health Care dollars are paying for this value.   The coming change will create new structures placing more risk across the system participants. 

The Wisconsin Family Care IRIS 2.0 implementation will need to facilitate a broad internal realignment.   These differentiated services will need to be measured distinctly and explicitly as part of the overall performance of the Family Care IRIS 2.0 Program.   This is arranging performance and contracting with partners who can profit from the relationship.

The success of the Wisconsin Family Care IRIS 2.0 Program is dependent upon construction of a foundation for performance and operating from a market position competitive to the model being replaced.    Conducive to this will be the side by side strength and quality of the relationships between the risk bearing participants:

-The Centers for Medicare and Medicaid and The Wisconsin Department of Health Services referred to as the Health Authorities. 

-The Integrated Health Agencies referred to as the key agencies.

-The Service Providers referred to as the contracted vendors.

Adequate numbers of contracted vendors will be directly related to traditional measures of success:

-          Growth an ability to experience gain

-          Profitability an ability to hold on to the gain

The Health Authorities will need to document evidence of value realized from the re-shaping of capabilities to facilitate implementation of meaningful innovations.

The Integrated Health Agencies will need to demonstrate the administrative support:

-          Policy to strengthen outcome within consistent operation

-          Outcome defined allocation

-          Transitional strategies

-          Internal links rapidly communicate best practice

-          Consistent claims process that works to retain vendor contracts- and pull new talent in

The appeal is to determine if Wisconsin Family Care IRIS 2.0 is a natural evolution of past practice or a whole new model of value based delivery. 

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