Historically, health plans focused medical management activities around utilization management and condition-specific disease management programs. New Medicare dictates require health plans to become more focused on quality and the acuity of their members in order to maximize revenue. But with many disparate systems, legacy systems, lack of IT resources, and overall lack of transparency and clarity within the organization, managing a healthcare business successfully in this new healthcare model has become complicated. In order to compete in a post-reform world, risk-bearing entities will be faced with the dual requirements of managing costs and revenue in an integrated manner. MedHOK unravels the complexities of this new world and offers steps to ensure success with value-based healthcare.