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 and 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 and Delivery
Implementation and facilitation of enhanced technology platforms that support speed, flexibility and real time enforcement of medical policy