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Pay-for-Performance Plan Design Solutions |
| Reden & Anders can help you examine health plan strategies, planning, development, and implementation of pay-for-performance programs. |
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Services & Tools:
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Actuarial Consulting
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Our actuarial consulting services help you predict and manage business risks, match revenues and expenses, and forecast demand. We help negotiate risk-adjusted contracts and develop products, services, and delivery systems. |
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Actuarial Toolbox
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Reden & Anders built a strong reputation in the health care industry by developing sophisticated tools and models that deliver value-added services to our clients. These tools are packaged together in the Reden & Anders Actuarial Toolbox™. |
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Contract Rate Model
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Reden & Anders helps you to calculate the average contract size (members per contract) and the average age-gender factor by contract type based on the inputted distribution of employees by age-gender-contract cohort. |
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Demand Forecasting Model
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The Demand Forecasting Model prepares forecasts of future health care demand by DRG, by product line (HMO, PPO, indemnity, Medicare, etc.), and by geographic location. For each product line, you can compare your current market share to current total demand to assess areas of investment for expansion. |
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Hospital Reimbursement Modeling
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The Reden & Anders Hospital Reimbursement Model provides employers with a powerful tool for evaluating varying reimbursement arrangements for inpatient hospital services.
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Inpatient Charge Forecaster
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The Reden & Anders Inpatient Charge Forecaster, developed from the Centers for Medicare & Medicaid Services (CMS) MEDPAR data, provides information on billed charge trends by hospital. Historical information is provided for a range of calendar years with annual trends conveniently summarized. |
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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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MEDPAR Data Sets
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Reden & Anders has accumulated vast amounts of deidentified insured health claims data which has been compiled into a longitudinal database encompassing a set period. Health insurance claims are reflective of an insured HMO Commercial population, as well as Medicare recipients. |
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Network Contracting Assistance
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Network contracting and evaluation is under scrutiny due to the ever increasing cost of providing health care benefits. Employer C-level executives are increasingly involved in health-plan decision making to help contain or reduce costs because these decisions impact their bottom line. |
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Networking & Clinical Care Management Tools
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Our clinical consulting team brings expertise and tools to all aspects of care management and quality improvement, enabling you to strengthen care and cost outcomes as well as measures of quality and performance. |
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Payer Consulting
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We help health plans—payers, insurance companies, managed care organizations—develop targeted strategies that more effectively attain financial goals and manage business risks, strategies that also improve medical cost structures, business operations, product development, provider contracting, and business information systems. |
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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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Physician Charge Profile
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The Reden & Anders Physician Charge Profile empowers you with an efficient method to evaluate physician fee schedules. The evaluation can be performed against any fee schedule, including the Medicare benchmark fee schedule. |
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Population Profiling
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Reden & Anders consultants can assist you with large-scale population profiling and studies. |
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Provider Contracting Tools
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Reden & Anders is a strategic partner to help you find, use, and analyze data to identify and evaluate providers that are superior performers. |
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Risk Management Consulting
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Risk management is a major part of your business. Yet the risks are greater than ever in today’s health care delivery system. Negative care and cost results are increasingly possible. |
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Services for Physicians and Medical Groups
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Industry trends can dramatically and quickly affect the bottom line of physician practices and medical groups. Our expertise and tools can help you plan for the future, better manage costs, negotiate more profitable contracts, and implement actionable business information systems. |
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Strategic and Operational Consulting
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Attaining broad organizational goals often depends on rethinking how things are done and how functional areas are organized and work together. In Strategic & Operational Consulting, we blend our health care and finance expertise to provide actionable advice on strategic business issues. |
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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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