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Product Strategy, Development, and Launch Services |
| Reden & Anders consultants work closely with you to evaluate your current Medicare market position, take optimal advantage of emerging opportunities, design new product strategies, and refine existing products. We focus on the financial viability of your offerings and work with you to develop operational, clinical, and marketing strategies. Reden & Anders can help you prepare applications for CMS filings for states, and implement successful product launches for Medicare Advantage, Medicare Supplement products, and Prescription Drug Plans. |
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Services & Tools:
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ASC Calculator
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The Reden & Anders ASC Calculator translates the various reimbursement allowances by the Medicare ambulatory surgical category (ASC) groupings into a single average reimbursement allowance per outpatient surgical encounter. |
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Excess-of-Loss Rating Model
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The Reden & Anders Excess-of-Loss Rating Models develop excess-of-loss premium rates for various populations with two tools; the Hospital Model calculates rates for hospital-only and global coverages and the Physician Model calculates rates for professional coverages. |
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Ingenix Health Technology Pipeline
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This management tool is one of the few publicly available sources of information that contains both a comprehensive identification of developing health technologies as well as a projected cost impact and suggestions for operational adjustments to minimize costs. It combines the clinical information in the pipeline with financial forecasts so you can anticipate your future medical expenses and plan accordingly. |
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Inpatient Charge Profile
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The Reden & Anders Inpatient Charge Profile, developed from the Centers for Medicare & Medicaid Services (CMS) MEDPAR data, provides information on billed charge levels by Major Diagnostic Categories (MDC) codes. Historical information is provided for multiple calendar years, with annual trends conveniently summarized. |
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Medicare 5% Sample
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The Reden & Anders Medicare 5% Sample Experience Trend Reports provide information on utilization, charge, Medicare allowed per service, and per member per month expense for service categories provided at the facility or by physicians. |
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Medicare Advantage Application & Implementation
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Since the mid 1980s, our highly experienced team of consultants has assisted scores of clients with Medicare managed care applications. We bring a multi disciplinary team to these engagements—clinicians, management consultants, actuaries, and professionals with expertise in administration, marketing, sales, compliance, provider relations, and other areas. |
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Medicare Advantage Financial Feasibility
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Reden & Anders helps you financially evaluate Medicare Advantage products. A typical Reden & Anders financial feasibility study includes actuarial estimates of medical expenses; administrative costs, including product launch, marketing, and sales; enrollment projections and timing; and pro forma financial projections for possible new products. |
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Medicare Advantage GAP Analysis
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Reden & Anders has extensive experience with the managed Medicare market and knowledge of the Medicare program and Medicare Modernization Act. With this knowledge, Reden & Anders can help you assess Medicare Advantage plan capabilities and challenges that you may have in implementing a Medicare Advantage product. |
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Medicare Inpatient Repricer
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Using the Medicare Inpatient Repricer (MIR), Reden & Anders can re-adjudicate DRG-based inpatient claims to determine exactly what CMS would have paid for them—for every hospital at any recent date. The MIR can also project them through the fiscal year. |
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Medicare Supplement Services
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The health insurance market for senior citizens is a large and growing market. Participating in this market is an important aspect of many carriers’ goals of market share and profitability. The primary vehicles to this market are Medicare+Choice managed care plans and Medicare
Supplement/Medicare Select insured products.
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Physician Charge Forecaster
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The Reden & Anders Physician Charge Forecaster, developed from the Medicare 5% Sample data, provides information on billed charge trends for specific codes and groupings of CPT codes for 35 specialties. |
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Questions?
To discuss how we can help your organization, please contact us:
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info@reden-anders.com or
(800) 765-6042 |
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