Analytics, Models
& Tool Development
How We Help
- Reimbursement modeling with market, payor & place of service specificity
- Customized case migration tool to more accurately predict future sites of care
- Project proforma & breakeven analyses
- Tailored volume, revenue, expense & performance KPI development
- Fee schedule & charge master evaluation
- Payor contract performance assessment
- Payor-specific negotiation prep & support
- ASC-specific financial review & benchmarking
Customer Solution
Reimbursement & Negotiation
Large, independent orthopedic & spine ASC with recent exit of hospital JV partners
Client Need
Following a large change in ownership & the surgeon roster, the client needed support assessing if their payor contracts were “good” and training internal staff to negotiate in the future.
- Evaluation of payor contract performance
- Negotiation support for immediate needs
- Staff education for long-term needs
Project Scope
- Strategy (New Market)
- Analytics
- Ongoing Advisory
LCHA Impact
- Developed summarized, updateable document to capture key terms & performance metrics
- Identified key carveouts to maximize gains on current &future procedure mix
- Established realistic targets for future negotiations
- Provided education on negotiation strategies, what payors are most/least likely to negotiate & potential risk areas
