PSS™ Payor Strategies and Solutions

equipping the forward-looking provider

National healthcare dynamics are requiring provider organizations to monitor their overall revenue portfolios consistently. Decreasing margins, changing payment methodologies, and a growing focus on transparency and consumerism all contribute to a complex healthcare reimbursement environment. With health plans increasingly focused on patient-centered and cost-effective payment transformation strategies, healthcare leaders must maintain a focus on payer partnerships and contracting strategies that position their organizations for long-term success.

Our Payer Strategies and Solutions (PSS™) solution set offers expertise for the forward-thinking provider by utilizing an end-to-end approach to payer strategy development, implementation and monitoring. This approach enables providers to maximize current financial performance while positioning them for future state success in a transforming market. Listed below are just a few of the offerings we provide our clients to support their journey.

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Offerings

Offering Listing

  • Market Assessment & Strategy Development
  • Rate Benchmarking
  • Service Focused Strategic Pricing
  • Value Based Contract Reconciliation
  • Contract Negotiation and Modeling Support


Analytics Listing

  • Dynamic Financial Modeler
  • Iterative Claims Reviewer
  • Rate Benchmarking Tool

Experience

Our Payer Strategies and Solutions team has a combined 55+ years of experience in various healthcare leadership and consulting roles within health plans, large hospital systems and physicians’ practices. This direct experience in payer contracting, practice management, reimbursement analytics and network development uniquely positions our team to support our clients in the areas of managed care strategy, implementation and monitoring needs.

Whether supporting payer contracting for mid-sized physicians’ groups or collaborating with health systems to develop transformational managed care/value based contracting strategies, we bring the unmatched expertise, understanding, and creativity required for the journey to risk capability.