In a recent two-part webinar series, the Baker Tilly healthcare consulting team discussed why a modern managed care environment (referred to as a payer performance management program) could be the right option for healthcare providers to ensure maximum reimbursement from third-party insurance companies as well as what tools and resources are most effective for implementation. We asked attendees questions about their current managed care operations and technology resources; see how your peers responded in the infographic below.
92 percent of webinar respondents feel their organization would benefit from a modernized payer performance management program.
Components of a modern payer performance management program
- Sophisticated contract modeling and rate setting capabilities
- Underpayment identification and Robotic Process Automation refiling
- Lost charge and DRG anomaly identification
- Up-to-date denial trending integration
- Advanced payer performance analytics
- 31 percent of respondents said their organization is currently using sophisticated rate modeling tools and software when evaluating proposals from payers or developing proposals to payers.
- 23 percent said their organization does not have a formal process in place to address payment discrepancies with payers.
- 41 percent of webinar respondents do not currently have the capability to produce advanced payer performance analytics.