Enhance healthcare efficiency with expert Payer and Provider Analytics. Maximize revenue, reduce costs, and improve practice performance with tailored solutions.
Detailed service structure and pricing model for Payer and Provider Analytics as part of our practice optimization:
Service Structure
1. Data Assessment and On-boarding
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Service Scope:
- Collect and review current data sources (EHR systems, claims data, financial reports, payer contracts, etc.).
- Evaluate data integrity, completeness, and compatibility.
- Establish a baseline for performance metrics.
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Deliverables:
- Data gap analysis report.
- Recommendations for data integration or software enhancements.
- Timeline: 2-4 weeks.
2. Payer Analytics
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Service Scope:
- Contract performance analysis: Evaluate reimbursement rates, claims processing times, and denials.
- Identify under-performing contracts and opportunities for renegotiation.
- Benchmark payer performance against industry standards.
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Deliverables:
- Payer performance dashboard with actionable insights.
- Contract renegotiation strategy.
- Timeline: 4-6 weeks.
3. Provider Analytics
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Service Scope:
- Productivity analysis: Assess provider performance based on RVUs, patient volume, and service mix.
- Cost and revenue analysis: Identify high-cost areas and revenue leakage.
- Quality metrics analysis: Evaluate clinical outcomes and patient satisfaction.
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Deliverables:
- Provider performance scorecards.
- Recommendations for workload balancing and efficiency improvements.
- Timeline: 4-6 weeks.
4. Integrated Analytics and Strategy Development
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Service Scope:
- Correlate payer and provider analytics to identify opportunities for cost savings and revenue growth.
- Develop a comprehensive strategy to optimize payer-provider alignment.
- Train stakeholders to interpret and act on analytics.
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Deliverables:
- Strategic optimization plan.
- Customizable dashboards for ongoing monitoring.
- Timeline: 4-8 weeks.
5. Ongoing Support and Reporting
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Service Scope:
- Monthly or quarterly performance reviews.
- Updates on payer trends and provider productivity metrics.
- Continuous improvement recommendations.
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Deliverables:
- Updated reports and dashboards.
- Scheduled consultation calls.
- Timeline: Ongoing.
Pricing Structure
1. Project-Based Pricing
- Initial Assessment and Setup: $10,000 - $20,000 (depending on practice size and data complexity).
- Payer Analytics Module: $15,000 - $25,000.
- Provider Analytics Module: $15,000 - $25,000.
- Integrated Strategy Development: $20,000 - $30,000.
- Total Package: $50,000 - $90,000.
2. Subscription-Based Pricing (Ongoing Support)
- Tier 1 (Small Practices): $2,500/month.
- Tier 2 (Mid-Sized Practices): $5,000/month.
- Tier 3 (Large Practices): $8,000+/month (customized solutions).
3. Hourly Consulting Rates (Ad-Hoc Support)
- Standard Rate: $300 - $500/hour.
- Bulk Packages: Discounts available for 20+ hours booked in advance.
Add-On Services (Optional)
- Custom dashboard development: $5,000 - $15,000.
- Training sessions for staff: $1,500/session.
- Advanced predictive analytics integration: Custom pricing based on scope.
This structure provides a balance between flexibility and value, catering to practices of various sizes while maintaining clarity in deliverables and pricing.