Call Now (561) 501-1747
Aligning Payers With Providers

ABOUT US

Founded in 2014, Pay For Performance, Inc. (P4P) applies over thirty (30) years of experience towards improving the managed care performance of healthcare payers and providers. Specifically, P4P leverages cutting-edge business intelligence technologies, comprehensive assessments, and the best Subject Matter Experts to deliver customized managed care improvement strategies and solutions that produce financial and operational results.

WHAT WE DO

Build Alignments

P4P assists your goals in building lasting payer and provider partnerships.  Through the use of a holistic assessment process, we help payers and providers establish mutual goals. Our assessment process includes a thorough review of claims data to compare overall financial and operational performance against expectations. We create Business Intelligence (BI) dashboards that leverage Artificial Intelligence (AI) algorithms to measure critical metrics. More importantly, our dashboard reporting provides the visual data associations that drive final engagement recommendations and planning.

To summarize, P4P’s alignment process includes:

  • Operational and Financial Review
  • Comprehensive Payer Contract Review
  • Claims Data Analysis utilizing BI / AI Dashboard Reporting
  • Resolution recommendation, planning, and implementation

Performance Management

To help maintain your organization’s key payer and provider partnerships, P4P provides performance management services. We examine and monitor the most significant managed care processes affecting managed care performance, including the following.
 

  • Payer Contract Rate Development
  • Payer / Provider Contract Negotiations
  • Network and Business Development
  • Strategic Planning
  • Financial Analysis
  • KPI Development and Reporting
  • Process Work Flows
  • Project Management
  • Policy Development
  • Customer Engagement
  • HEDIS, STARS Quality Management

WHAT WE PROVIDE

Our Core Deliverables

Our deliverables are only limited by our client’s imagination. That said, P4P’s typical performance improvement requests include the following items:

  • Integrated Business Intelligence Dashboard Reporting including:
  1. Employer performance data
  2. Service Line performance data
  3. Revenue performance data
  4. Cost performance data
  5. Receivables performance data
  6. Payer performance data
  7. Product Line performance data
  8. Provider performance data
  9. Geo-Access performance data
  10. Coding / Clinical data
  • Revenue gain and Cost reduction opportunities
  • Process / Policy improvement recommendations
  • Partnership strategy recommendations
  • Business line Development Opportunities
  • Customer / Network Development Opportunities
  • Marketing Development Opportunities
  • Key Performance Indicator (KPI) Benchmarking

Our Value Proposition

P4P’s value proposition is its ability to provide customized assessments and analyses that produce actionable performance improvement strategies, recommendations, and solutions. P4P begins its process by building a personalized team for each client engagement.  We provide each unit with a suite of intuitive and powerful BI tools that produce exceptional analytical reporting capabilities including;

  • Disjoined data integration
  • At-will reporting
  • Intuitive data visualization – BI Dashboards
  • KPI Management
  • Identification of Alignment Opportunities
  • Identification of Improvement Opportunities

Overall, P4P provides expert managed care consultants combined with its extraordinary data analysis technologies that allow for the quick identification and development of provider and payer partnership solutions.

Our approach

Through comprehensive assessments and data analysis, P4P identifies corporate alliances among payers and providers. P4P works with each client to develop shared interests that promote partnership solutions and avoids punitive tactics. Our approach helps position payers and providers for success through common goal alignments, while our healthcare analytics solutions help our clients monitor and manage their business.  To maintain their performance, P4P offers on-going support, advice, and data analysis.

 

In summary, P4P’s approach is as follows.

 

  • Identify Payer and Provider Alignments
  • Promote Partnerships and discourages divisive tactics
  • Position Payers and Providers to work towards common goals
  • Provide BI Reporting Solutions to self-monitor goal performance
  • Offer on-going support to ensure performance remains on-track

Schedule a free consultation today! (561) 501-1747

Learn more about Pay For Performance’s managed care solutions.