Product Overview
Value-Based Payment & Insight
Value-Based Payment Initiatives Have Moved Beyond Isolated Pilots For Micro-Segments Of Members And Providers; Today’s Healthcare Organizations Need Sophisticated Technology To Manage Complex Programs For Populations Across Multiple Lines Of Business.
End-to-End Value-Based Payment Program Development & Administration is Here
It’s time to move your value-based payment programs out of the infancy of isolated pilot projects and kludgy systems into an enterprise-wide, standardized, and automated solution that unlocks the true potential and impact of alternative payment models and value-based care. You may already have a successful workflow, but do you have a centralized platform for the development and administration of all value-based payment contracts, regardless of line of business, alternative payment model, or arrangement complexity? Are you equipped to rapidly scale to the growing demands of value-based payment programs?
Population Payment Management
For 26 years, Edifecs has been orchestrating, connecting, and processing nearly all data categories most critical to impactful value-based payment programs. With a combined 150 years of experience in value-based programs, our subject matter experts are key contributors to organizations defining industry standards to advance value-based payment programs. Developing solutions enabling healthcare organizations to build, administer, monitor and optimize the performance of value-based payment programs to improve quality care, health equity, and health outcomes is a natural extension of our core competencies and expertise.
Standardize and automate the development and administration of value-based payment programs
Establish corporate standards and global rules for value-based payment contracts
Provide transparency in payment methodology and reporting between stakeholders and decision-makers (payers, providers, partners)
Optimize value-based payment programs for improved performance year-over-year
Scale value-based payment programs and improve provider adoption through the reuse of successful program models captured in user-configurable templates
Specifications
Population Payment Management
Purpose-Built Technology Designed To Exceed The Demands Of Value-Based Programs At Scale – No Matter The Complexity Or Volume Of Contracts.
Value-Based Payment Initiatives Have Moved Beyond Isolated Pilots For Micro-Segments Of Members And Providers; Today’s Healthcare Organizations Need Sophisticated Technology To Manage Complex Programs Across All Payment Models And Lines Of Business. Unfortunately, Many Solutions In The Market Today Were Originally Built Upon A Framework That Only Supported Smaller Scale Initiatives, As Well As Only Supporting A Small Segment Of Payment Arrangement Models Such As Shared Savings Or Episodes Of Care, And Are Not Able To Either Scale Or Support Programs Planned On The Strategic Roadmap.
Administer Programs with Confidence
Employ a trusted, enterprise SaaS platform fully managed in a FedRAMP environment
Leverage actuarially sound templates, processing, attribution, cost and risk adjustments, and payment calculations
Automate and Standardize Value-Based Programs
Deploy preconfigured program templates, workflows, and immediately usable reports which contain valuable performance insights
Quickly and easily design new program templates tailored for your network development needs and value-based program goals
Eliminate reliance on manual processes, spreadsheets, and cobbled together tools, via a comprehensive, enterprise-wide platform approach
Centralize the development and administration of all value-based payment programs regardless of line of business, alternative payment model, or arrangement complexity
Gain Critical Insights for Greater Impact
Gain predictive insight into future cost impacts and changes to payment arrangement and/or methodology
Optimize value-based payment programs for improved performance year-over-year with real-time insight into financial, quality, and contractual outcome performance
Improve provider engagement, alignment, and satisfaction through transparency in payment methodology and reporting real-time, auditable, and accurate data
Scale Value to 100%
Expedite time-to-market by launching new programs based upon successful models' templates
Identify risk readiness based upon quality performance and medical spend
Identify value-based opportunities via historical and ongoing program analysis
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