Population Payment
Management

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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.

Population Payment Management (PPM) is the largest and most comprehensive value-based payment (VBP) processing platform on the market. Our SaaS-based solution supports thousands of VBP contracts across all HCPLAN categories, covering over 20 million lives and connecting payers and providers to create transparency and establish a single source of truth for value-based contracts.

PPM’s actuarially sound configurable framework helps payer and provider organizations more effectively manage attribution and deliver real-time financial benchmarking, performance monitoring, and financial settlements for both primary care and specialty value-based payment programs. And with AI-powered forecasting and insights, PPM gives payers and providers the confidence they need to scale their value-based programs.

Accelerating the Shift to Value

Edifecs' Population Payment Management solution can help healthcare organizations overcome those challenges and accelerate the shift to value.

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Collaborate

  • Gain real-time continuous tracking & insights into provider performance
  • Leverage performance data to assess risk readiness and inform pre-contract negotiations
  • 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.

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analyze

  • Leverage insights to optimize past, present, and future value-based program performance
  • Identify value-based opportunities with historical and ongoing program analysis
  • Help providers maximize savings and minimize losses to encourage adoption

Achieve continuous improvement

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

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predict

  • Accurately forecast future cost impact of changes to payment methodology
  • Utilize historical performance data to measure provider risk in new APMs
  • Identify models that can deliver mutually beneficial outcomes and cost savings

Leverage cutting-edge technology

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

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standardise

  • Automate manual contracting workflows and processes
  • Develop and administer complex value-based programming for all lines of business
  • Reduce administrative challenges with actuarially sound templates

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.

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grow

  • Minimize the administrative hurdles of expanding your value-based business
  • Strengthen provider trust and buy-in with AI-enabled modeling & forecasting
  • 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.

Find out how we can support your health plan's performance.