How does P4P stimulate growth through Performance Management? We begin with careful client counsel using comprehensive assessment tools to identify appropriate measures for improvement. Next, P4P designs custom performance management solutions around the processes, as listed below.
Performance Management Overview
Strategic Planning
Strategic planning provides the core of any performance management effort. Our process P4P begins with a review of the client’s Comprehensive Managed Care (CMC) strategy. If the parties determine that the CMC strategy is inadequate, then P4P can help cultivate a CMC strategy. Next, P4P’s uses its assessment process to maximize those uncovered functions in alignment with the CMC strategy. P4P also identifies and provides remediation steps for those supporting functions in misalignment with the CMC strategy. In short, P4P’s complete strategic planning process offers the managed care support you need to fulfill your goals!
Strategic Planning
Strategic planning provides the core of any performance management effort. Our process P4P begins with a review of the client’s Comprehensive Managed Care (CMC) strategy. If the parties determine that the CMC strategy is inadequate, then P4P can help cultivate a CMC strategy. Next, P4P’s uses its assessment process to maximize those uncovered functions in alignment with the CMC strategy. P4P also identifies and provides remediation steps for those supporting functions in misalignment with the CMC strategy. In short, P4P’s complete strategic planning process offers the managed care support you need to fulfill your goals!
Customer Engagement
P4P’s pays specific attention to supports its client’s customer engagement efforts. We believe that all payers, providers, and employer groups can influence each other’s business; therefore, they each serve in a customer role. We strengthen patient, provider, payer, and employer partnerships through the development mutual customer engagement efforts; including, Customer Identification, Customer Acquisition, Customer Retention, and Customer Referral.
Network and Business Development
Network/business development is a critical component of business growth. Unfortunately, mergers, acquisitions, expansion, terminations, regulatory changes, medical advances, and new services can impede an organization’s ability to respond to new demands. P4P provides support with provider network builds, updating outdated agreements, adding new reimbursements or regulatory language. Without delay, P4P can deploy an elite team of contractors experienced in working with integrated health systems, hospitals, physicians, ancillary, behavioral health, dental, vision, or other specialty provider service contracting. In addition to staff sourcing, P4P provides sophisticated project management, reporting, credentialing, site visit, and training, that serves as a turn-key network development solution!
Network and Business Development
Network/business development is a critical component of business growth. Unfortunately, mergers, acquisitions, expansion, terminations, regulatory changes, medical advances, and new services can impede an organization’s ability to respond to new demands. P4P provides support with provider network builds, updating outdated agreements, adding new reimbursements or regulatory language. Without delay, P4P can deploy an elite team of contractors experienced in working with integrated health systems, hospitals, physicians, ancillary, behavioral health, dental, vision, or other specialty provider service contracting. In addition to staff sourcing, P4P provides sophisticated project management, reporting, credentialing, site visit, and training, that serves as a turn-key network development solution!
Business Intelligence Reporting
Reporting provides critical knowledge into your managed care business; however, many reports are disjointed, untimely, and difficult to interpret. For these reasons, isolated reports often fail to be useful management tools. Leveraging Business Intelligence (BI) technologies, P4P transforms your data into intuitive pictographs, dashboards, and scorecards resulting in more effective communication, monitoring, and management of your business. Data relationships are built between payers, providers, medical services, and sponsoring employer groups, drawing insights into the “cause and effect” of your financial performance. P4P’s BI reporting can use data extracts; therefore, it can be deployed quickly without costly software investment or system integration concerns. P4P BI solutions offer intuitive reporting, on your terms, 24-7 on any web-enabled device!
Payer Contract Rate Development
Payment methodologies come in all shapes and sizes, including; Capitation (Full-Risk or Gain Share), Fee for Service, Bundled Payments, Value-Based Purchasing, and Incentive Bonuses, to name a few. However, finding the right reimbursement and payment methodology that promotes “Quality of Care” can be elusive. P4P helps your organization review, develop, and monitor the appropriate reimbursement program to meet your goals!
Payer Contract Rate Development
Payment methodologies come in all shapes and sizes, including; Capitation (Full-Risk or Gain Share), Fee for Service, Bundled Payments, Value-Based Purchasing, and Incentive Bonuses, to name a few. However, finding the right reimbursement and payment methodology that promotes “Quality of Care” can be elusive. P4P helps your organization review, develop, and monitor the appropriate reimbursement program to meet your goals!
Payer / Provider Contract Negotiations
P4P believes in establishing fair, equitable, and sustainable partnerships. Understanding market dynamics is a critical step. P4P makes certain to gain a 360-degree view of the market, including barriers that may impede upon reaching reasonable resolutions. Additionally, P4P ensures that your agreements are administrable by providing extensive contract language and rates review. P4P’s impartial negotiation process allows it to focus on the following;
- Alignments that move beyond differences
- Time value over partisan debates.
Whether you are a provider or payer, P4P’s expert negotiating experience can help you mediate your differences!
Policy and Process Improvement
Healthcare is complicated and continually evolving. Notably, new regulatory requirements can create a rippling effect throughout your organization. P4P has the necessary Subject Matter Experts to review your internal processes and ensure relevance, compliance, and “best practice” standards implementation.
Policy and Process Improvement
Healthcare is complicated and continually evolving. Notably, new regulatory requirements can create a rippling effect throughout your organization. P4P has the necessary Subject Matter Experts to review your internal processes and ensure relevance, compliance, and “best practice” standards implementation.
Project Management
Healthcare requires constant monitoring, especially with large scale projects. Regrettably, not all organizations have dedicated or available Project Managers. P4P has skilled Project Managers empowered with sophisticated Project Management, Customer Relations Management (CRM), and Workflow technologies to ensure that your project stays on track and budget.
HEDIS, STARS Quality Management
As more emphasis is being placed on HEDIS and STARS results, payers are setting higher provider expectations on improving their outcomes. It can be challenging to identify and manage patients who have the most significant impact on your quality scores. P4P can help stratify and prioritize your patient data and develop strategies for achieving higher HEDIS and STARS outcomes!
HEDIS, STARS Quality Management
As more emphasis is being placed on HEDIS and STARS results, payers are setting higher provider expectations on improving their outcomes. It can be challenging to identify and manage patients who have the most significant impact on your quality scores. P4P can help stratify and prioritize your patient data and develop strategies for achieving higher HEDIS and STARS outcomes!