We develop bundled payment networks and deliver technology solutions to integrate these networks into a payer’s benefit plans and case management programs. We also enable a new generation of health insurance benefit plans that leverage bundled payment contracts.
The Challenges We Address
- Organizing networks of providers into bundled payment contracts
- Fostering greater competition
- Managing expensive episodes of care
- Engaging specialists
- Empowering primary care physicians in population health programs to make
more informed decisions when referring patients to specialists
Our Solutions
Bundled Payment Networks
We enter into contracts with payers to accept a fixed price for a patient’s entire episode of care. We succeed by establishing partnerships with healthcare organizations to jointly serve each payer’s enrolled beneficiaries.
Our Network services to payers includes:
- Recruiting, training and managing networks of healthcare
providers under at-risk bundled payment contracts - Enabling payers to design and implement bundled payment programs
- Delivering a comprehensive analytics platform for pricing, monitoring and reporting
- Administering reconciliations and gain sharing
Learn more about Bundled Payment Networks
Innovative Episode Benefit Plans
Financing healthcare around patient episodes opens new avenues for benefit plan design. This new category of health plan can achieve the premium rates equal or below narrow network plans – while remaining more attractive to enrollees.
We enable this new class of benefit plan with:
- Specialized software to administer Episode Based Benefit Plans, including bundling engines and claims handling modules.
- Content assets that include over 400 episode definitions; regulatory filings for product Riders; Episode pricing methodologies; provider contract library; and, premium rating methodologies.
- Comprehensive cloud-based software platform with workflow, authorization and decision-support tools.
What We Do
