We’ll help you turn healthcare and payment reform into a strategic advantage
Edifecs Population Payment Management enables health plans to seamlessly scale and efficiently manage their shared savings, episodic and P4P programs. It models and analyzes impact of shifts in reimbursement from fee-for-service to value-based care payment model. Health plans can perform "what-if" analysis of future medical costs and gain enhanced intelligence into risk of their member population via risk stratification. Flexible templates reduce program design complexity and impactful analytics improve performance for both health plans and providers while also enhancing provider buy-in.
Edifecs Population Payment Management Episodes of Care Module automates the complete episode management lifecycle, from design to management to audit and reconciliation with external third party payers. It evaluates historical and current performance of providers to identify preferred episode collaborators. IDNs, hospitals, physicians and post-acute care providers can leverage the module to manage alternate episode-based payment models such as Comprehensive Care for Joint Replacement, bundled payments including common cardiac, oncology care etc.
Edifecs Population Payment Management Shared Savings Module operationalizes shared savings program from design to management to audit and reconciliation with external third party payers. Pre-defined and custom program templates expedite the program design process. Health plans can perform budget analysis and projections and monitor progress of ongoing shared savings programs, review provider performance, perform payment settlements and generate shared savings reports.
Deftly target specific provider networks and member populations:
Model and analyze financial arrangements. Leverage program templates
Ensure complete and timely financial and population health transparency
Intelligently optimize program operations and drive value-based care and reimbursement initiative scalability