Aspect Procedure-Based Reimbursement Episode-Based Reimbursement Definition Payment model where healthcare providers are reimbursed for each procedure or service provided. Payment model where providers are reimbursed a lump sum for all services delivered during a specific episode of care. Focus Individual services and procedures. Bundled services within a defined episode of care (e.g., surgery, recovery, rehabilitation)….
Feature Bundled Service Pricing Unbundled Service Pricing Definition A pricing strategy where multiple services are sold together as a single package at a set price A pricing strategy where each service is priced individually and sold separately Revenue Model Revenue is generated from the sale of a package of services, often leading to predictable income…
Feature Population-Based Pricing Models Shared Savings Models Definition Pricing models where the cost is determined based on the overall health of a population, aiming for holistic management A model where providers share in the savings generated from reducing healthcare costs below a predefined target Revenue Model Revenue is based on managing the total cost of…
Feature Risk-Based Pricing Models in MSOs Episodic Care Pricing Models Definition Pricing model where costs are based on the risk profile of the patient population or specific conditions Pricing model where costs are determined based on the specific episode of care, often including all related services from start to finish Revenue Model Revenue is adjusted…
Feature Value-Based Pricing Monthly Fixed Pricing Definition Pricing based on the value delivered to the client, often linked to outcomes and performance metrics Pricing based on a fixed monthly fee regardless of service usage or outcomes Revenue Generation Revenue varies based on the value or outcomes achieved, potentially higher with better performance Revenue is steady…
Feature Fixed Pricing Model Variable Pricing Model Definition Set price for services regardless of usage Price varies based on usage or volume of services Pricing Structure Fixed fee per service or contract Per unit, per transaction, or usage-based fee Predictability High predictability for budgeting and forecasting Less predictable, can vary with service usage Revenue Stability…
Feature Healthcare Performance Improvement Programs Quality Assurance Programs Objective Enhance overall performance and efficiency Ensure compliance with established standards Focus Continuous improvement and innovation Maintaining quality and preventing errors Methodology Data-driven strategies, Lean, Six Sigma Standard operating procedures, audits, inspections Scope Broad, encompassing all aspects of healthcare delivery Specific, focused on predefined quality standards Approach…
Feature Integrated Care Pathway Management Standard Care Pathway Services Scope of Services Comprehensive integration of all care pathways Focus on individual care pathways without integration Patient Coordination Seamless coordination across multiple care settings Coordination within specific care settings Care Continuity Ensures continuous care transitions Care transitions may have gaps Interdisciplinary Collaboration Promotes collaboration among diverse…
Aspect Cost-saving Solutions Revenue-enhancing Solutions Definition Solutions aimed at reducing operational costs and optimizing resource allocation. Solutions designed to increase revenue through new opportunities and enhancements. Objective Focus on minimizing expenditures and improving cost-efficiency. Focus on maximizing income and enhancing financial performance. Implementation Focus Streamlining processes, reducing waste, and optimizing resource usage. Identifying growth opportunities,…
Aspect AI-powered Solutions Human-powered Solutions Definition Solutions that utilize artificial intelligence, machine learning, and automation to perform tasks and make decisions. Solutions that rely on human expertise, judgment, and manual processes to deliver services and solve problems. Technology Integration Incorporates advanced algorithms, data analytics, natural language processing, and automation technologies. Utilizes human skills, knowledge, and…