Doctor greeting patient in wheelchair

Infographic: Implementing a modern managed care environment for your healthcare organization

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

Key findings

  • 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.

For more information on this topic, or to learn how Baker Tilly healthcare specialists can help, contact our team.

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