We sat down with Lisa Schulte, Vice President of the Commercial Group at Remedy Partners. Lisa and her team are responsible for the development and rollout of Remedy Partners’ commercial payer and provider solutions.

What led you to join Remedy Partners? 

In my over 20 years of executive leadership roles in healthcare technology and operations, I have seen first-hand how the Fee-for-Service model in healthcare fuels unnecessary services and cost. Remedy Partners’ vision supports lasting change in the delivery of care to a patient by aligning payer and provider incentives to offer care in a manner that centers on the patient’s full episode of care. This creates a high degree of cohesiveness, coordination and quality in the delivery of healthcare services. Working with an organization that supports a new paradigm in healthcare that focuses on value creation and genuinely reshaping how patient care is delivered is the only place I want to be.

How do payers benefit from Remedy Partners’ episode of care based offerings and what problems do you help them solve?

Remedy Partners’ offerings benefit payers who understand the long-term value of moving from a 100 percent Fee-for-Service volume-based model of healthcare reimbursement, to a value-based model of reimbursement. A business model focusing on value begins to address key pain points facing payers today and facilitates a greater degree of provider and patient engagement, increasing both financial and quality outcomes for payers.

Some of the types of problems we help payers solve include:

• Total cost of care–We provide analytical insight into the most expensive episodes of care and generate payer specific savings opportunities. Our solutions also drive a greater degree of control and predictability of medical spend through bundled payment contracts.
• Transparency across patient care spectrum–We provide transparency of patient condition status and drive a higher degree of care coordination through the use of patient tracking and decision support tools.
• Access to commercial bundle definitions–We currently support a library of 382 proprietary bundle definitions and can also tap into open source definitions available in the market.
• Availability of bundled payment contracts–We are building a turn-key bundled payment network that payers can use immediately to administer and support bundled payment programs.

Remedy Partners also offers the opportunity for payers to expand their traditional benefit plan product portfolio and offer episode of care based benefit plan designs. The offering is turn-key and includes all of the business and technical components and features required to underwrite, sell and administer episode based benefit plans.

We have mostly been talking about payers, but do your offerings also address providers and their unique challenges in working with payers and bundled programs?

Yes, Remedy Partners offers unique commercial solutions that are inclusive, designed for both the provider and the payer. We believe that both parties must be supported in order to create lasting value in the industry. We leverage many core assets across our payer and provider customer groups including our bundle definitions, analytics platform, financial management services, decision support and patient care tools, and our reporting and training platforms.

How do your solutions address provider challenges?

Payer organizations are increasingly approaching providers with opportunities for participation in bundled payment programs. Their offers are many times confusing and generally lacking in detail. Remedy Partners has developed a robust bundle engine capable of ingesting payer claims data, while coding to a broad scope of definitions and risk formulas.

Another challenge faced by providers is the number of unique systems or interfaces they must use to administer care and maximize revenue. Remedy Partners offers a single multi-payer administrative platform for bundle management. Our comprehensive platform supports: a horizontal view of care for a patient, bundle specific risk assessments for proper determination of patient bundle eligibility, risk adjustments, bundle specific best practices, a display of efficient downstream providers related to delivery of medical services included in the bundle, and real-time claim activity totals relative to bundle target price.

How have your past work experiences impacted the work you are doing today?

My past work experiences in healthcare operations, specifically seeing what wasn’t working with the Fee-for-Service model, have allowed me to expedite my contributions to Remedy Partners’ market value and success through the build out of our commercial offerings. Without the foundation of working within both health plans and provider organizations, I would not have been able to contribute at the speed and level that I have over the past year at Remedy Partners. Value creation and successful delivery of value to the market have been two principle tenets throughout my career, and it is a privilege to work with a company that shares and embodies these tenets.