Population Payment Management Header Image

Population Payment
Management

Value-based payment initiatives have moved beyond isolated pilots for small segments of members and providers. Today’s healthcare organizations need sophisticated technology to manage complex programs with various payment models across all lines of business.

Unfortunately, many of the solutions in the market today were built to support smaller-scale initiatives and payment arrangement models, such as shared savings or episodes of care. Population Payment Management is designed to scale and support the full range of value-based programs and payment arrangements on healthcare organizations’ strategic roadmaps.


Payers. Providers. Patients. Connected.

It’s time for payers and providers to change the game by leveraging Edifecs’ interoperability platform and business applications to innovate, collaborate, and ultimately deliver better care.


Opportunity Awaits. Are You Ready to Capitalize?

Learn how Edifecs can help you achieve these outcomes.

Population Payment Management Solution 1
collaborate
  • Gain real-time tracking & insights into provider performance
  • Leverage performance data to assess risk readiness
  • Create a single source of truth for all stakeholders with accessible reporting

Support your network

Deliver the transparency and clarity provider partners need to enter into alternative payment models with confidence.

Value-Based Payments 2
analyze
  • Leverage insights to optimize past, present, and future value-based program performance
  • Identify value-based opportunities with historical and ongoing program analysis
  • Improve provider engagement with actionable performance insights

Achieve continuous improvement

Gain real-time insights into financial, quality, and contractual outcome performance to improve provider engagement and maximize value-based opportunities.

Edifecs Population Payment Management 3
predict
  • Accurately forecast future cost impact of changes to payment methodology
  • Gain a complete understanding of provider risk in new APMs based on historical performance data
  • Perform “what-if” modeling to identify models that can deliver mutually beneficial outcomes and cost savings

Leverage cutting-edge technology

Predictive modeling leverages ML & AI technology to deliver an accurate picture of expected provider performance in different payment arrangements and/or methodologies.

Population Payment Management for Healthcare 4
standardize
  • Automate manual contracting workflows and processes
  • Seamless development and administration of any value-based program, regardless of complexity or line of business
  • Reduce administrative challenges with actuarially sound templates, processing, attribution, cost & risk adjustments, and payment calculations

Streamline workflows

Deploy pre-configured value-based program templates and workflows, or design new program templates based on your organization’s needs and goals—all from one centralized hub.

Population Payment Management Edifecs 5
grow
  • Minimize administrative hurdles to more effectively capitalize on value-based opportunities
  • AI-enabled modeling improves provider trust and buy-in for faster expansion of value-based programs
  • Improve organizational agility and readiness for faster time-to-market

Expand your footprint

Accelerate time-to-market with new programs built on the templates of previously successful models. Identify value-based opportunities and determine risk readiness with historical and ongoing analysis.


News & Insights

Population Payment Management for Value-Based Care Programs
Value-based care is essential to improving health outcomes and reducing the rapidly rising costs of healthcare. In this brochure, we provide an in-depth description of our value-based payment and insight solution to enable the development, monitoring, optimization, and reporting of value-based care programs.
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Improving Financial Performance Infographic
If your health plan revenue could use a lift, this two-prong approach—accelerating the transition to value-based care (VBC) and ensuring complete and accurate payments—are proven paths to net additional income.
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Strategies to Improve Financial Performance eBook
in order to deliver quality care in a competitive landscape where healthcare costs continue to rise, cutting costs isn’t enough—healthcare organizations need to maximize their top-line revenue as well. In this eBook, we explore how health plans can achieve both cost reduction and revenue maximization.
Learn More  ❯
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