Provider

Provider

Hospitals and Health Care Systems

Creating strategies that ensure a financially sound future for your organization

There’s never been a more challenging time to deliver high quality patient care while maintaining your organization’s financial viability. Current market trends—potential revenue shortfalls due to reimbursement and uninsured issues; capacity issues; difficulty in accessing capital to invest in facility improvements and new technology; and a growing aging population—demand thoughtful planning. With limited resources, it’s even more critical to carefully anticipate future needs and financial risks as well as plan investments in specialty areas like Cancer Care Centers or Transplant Services.

Physicians and Medical Groups

Sharpening the competitive edge of physician practices and medical groups

Because physician practices and medical groups often operate on a smaller scale than hospitals, market forces may matter more to their bottom line, negatively affecting both clinical and financial outcomes. If not properly managed, revenue shortfalls due to reimbursement issues, lack of investment in facilities and technology, and poorly negotiated contracts could dramatically and swiftly affect your organization’s financial future.


Solutions:


Clinical and Cost Management Solutions
The Reden & Anders clinical team has extensive experience in all aspects of medical management. Our consultants perform in-depth analysis of care management capabilities, compare to industry best-of-class, and then develop practical strategies. The team has analysis, design, and development capabilities across the medical management spectrum including disease management, health and wellness, utilization management, case management, pay-for-performance (P4P) programs, Centers of Excellence, benefit design, predictive modeling, and physician profiling.
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Contracting and Pricing Solutions
Reden & Anders has expertise in HMO/PPO contract negotiations, and our experienced consultants can provide Medicare and Medicaid financial analyses around capitated downstream risk from health maintenance organizations (HMOs) and preferred provider organizatiosn (PPOs).
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Demand Forecasting, Capacity Investments, and Cost Management Solutions
Reden & Anders experts can help hospitals and health care systems forecast inpatient, outpatient, and physician demand. In addition, we can help with market assessment and future capacity planning, specialty physician planning, and capital investment analysis.
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