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Reden & Anders provides payer contracting support services to hospitals throughout the entire negotiation process, including identification of opportunities and strategies to achieve them, negotiation support, and analytics modeling of the financial effect of changing reimbursement terms.
Reden & Anders will help hospital payer contracting departments:
- Identify where reimbursement levels are at risk
- Identify actionable negotiation leverage points
- Develop contract rate proposals
- Determine the financial impact of various contract scenarios
- Provide assistance with payment disputes, should they arise
In addition to providing fee-for-service based contracting support, Reden & Anders also can help hospitals better understand their risk associated with capitated risk arrangements from payers.
Reden & Anders will help hospitals and integrated provider delivery systems assess their financial risk of entering into, or remaining in, capitated reimbursement contracts with payers as follows:
- Identify medical services scope for which provider organization is at risk
- Compare capitated payment to fee-for-service equivalent PMPM medical expense budgets developed by Reden & Anders
- Perform sensitivity testing of varying medical utilization performance assumptions to assess financial performance under the contract.
Reden & Anders relies on one of the largest health care claims databases in the health care consulting industry, which puts us in the enviable position of providing more accurate projections of financial risk under varying contractual arrangements between payers and providers.
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