Medical Cost Optimization
Our medical cost optimization offering delivers customized solutions to our clients by defining key medical policy strategies, analyzing medical spend using in-house tools, and leveraging data driven insights. We work with you to evaluate the effectiveness of higher cost medical procedures in achieving reduced overall costs and improved patient care.
Key features and capabilities
- Data driven insights that inform business decision making and support faster response times to acuity of care outliers through preventative measures
- Process Enhancements that reduce improper adherence through improved workflows enabling health plans to operate across a transparent, administratively simple ecosystem
- Tailored transformation approach to each individual client situation showcasing the platform and tools that facilitate an enhanced data ecosystem addressing existing inadequacies
- Enhanced operational visibility through process benchmarking providing insight into areas of high medical spend, improper configuration, and a holistic view of medical policy operations
- Thorough documentation supplied by the project playbook to accelerate platform integration and manage the transition to the desired future state
Our Services
Policy Optimization- Roadmap Solution
Standardized medical policy processes and the fine-tuning of operations to enable interoperable infrastructure with increased policy adherence
Medical Policy Strategy - Gap Assessment
Appraisal of current policies against industry best practices through assessing the level of organizational adherence and optimization throughout care coordination processes
Data Driven Management and Measurement - Implementation Pod & Delivery
Implementation and facilitation of enhanced technology platforms that support speed, flexibility, and real time enforcement of medical policy