Future Healthcare Today
  • About
  • Payer
  • Provider
  • Pharma & Life Sciences
Subscribe
No Result
View All Result
  • Digital Transformation
  • Telehealth
  • Cybersecurity
  • Patient Experience
  • Clinicians
  • Resources
    • COVID-19
Future Healthcare Today
  • Digital Transformation
  • Telehealth
  • Cybersecurity
  • Patient Experience
  • Clinicians
  • Resources
    • COVID-19
No Result
View All Result
Future Healthcare Today
No Result
View All Result
Home Digital Transformation

Cost Management Strategies Deliver Increased Savings

by Kelsey Winick
March 30, 2022
in Digital Transformation, Patient Experience, Payer
Reading Time: 3 mins read
A A
Cost Management Strategies
Share on FacebookShare on Twitter

The No Surprises Act was implemented on January 1st of this year. Loren Adler, Assistant Director of the USC-Brookings Schaeffer Initiative for Health Policy, shared that the Act “is one of the biggest consumer protections to pass in recent decades.” The Act protects patients from unexpected charges when receiving care from out-of-network (OON) providers. While the Act delivers many positive outcomes for patients, payers and providers have been left to settle disputes over how to cover the rest of the bill. 

Health plans and third-party administrators (TPAs) need to look further than their current approach to claims. Payers have traditionally used a fixed, singular strategy, which leads to over-payment and results in millions of dollars of additional costs for the business. Instead, innovative solutions from trusted healthcare savings solutions partners can find the balance between savings, provider acceptance, and reducing the time to settlement. Additionally, trusted partners can assist with negotiating and settling a dispute if one were to arise. If the dispute cannot be resolved and is transitioned to the Independent Dispute Resolution (IDR) process, partners can offer support and help navigate the proceedings. This final-offer arbitration process will use a government-approved entity to choose either the payer’s or provider’s offered rate as a final determination.

These cost management strategies incorporate the benefits from multiple channels on a claim-by-claim basis that maximize savings and meet provider acceptance, rather than stopping at the first discount found. Dynamic, optimized solutions are able to route claims to designated channels that decide the appropriate savings and maximize the OON claims savings. This leverages savings options and draws attention to savings instead of discounts. These solutions go further than the savings. These strategies consider the impact of all stakeholders from members, payers, and plans to providers.

The goal is to drive savings for payers and plans while reducing the risk of provider abrasion. This happens when the relationship between payers and providers becomes negatively influenced by certain situations, usually disputes about claims payments. Payers can avoid provider abrasion with fair market reimbursement offers, greater transparency, and timely payments.

An end-to-end strategic solution supports the needs of TPAs and health plans by increasing savings, while remaining aware of the balance between payers and providers. Strategies backed by savings solutions partners help support the relationships between payers and providers and find solutions to cost management goals. 

Tags: Cost ManagementNo Surprises ActPayerProviderSavingsTPAZelis
Advertisement Banner

RELATED POSTS

IDR Process
Digital Transformation

CMS Looks to Simplify IDR Process: Part 3 of New Regulatory and Legislative Activities for CMS

January 20, 2023
Advanced Explanation of Benefits
Digital Transformation

Advanced Explanation of Benefits: Part 2 of New Regulatory and Legislative Activities for CMS

January 19, 2023
National Provider Directory
Digital Transformation

National Provider Directory: Part 1 of New Regulatory and Legislative Activities for CMS

January 18, 2023

TRENDING NOW

  • Redefining the Patient Experience with Artificial Intelligence

    Invest in Your ‘Copier Center’ for the Future of your Health System’s Mission

    504 shares
    Share 202 Tweet 126
  • With Worker Shortage, Here’s How Healthcare Facilities Can Attract New Talent

    504 shares
    Share 202 Tweet 126
  • AI Solutions Can Improve Hospital Operations and Physician Well-being

    499 shares
    Share 200 Tweet 125
  • How Healthcare Organizations Can Manage Data in a Scalable, Secure, and Auditable Way

    531 shares
    Share 212 Tweet 133
  • NYC Health + Hospitals Takes Control of its Data to Deliver Patient Outcomes

    609 shares
    Share 244 Tweet 152

CONNECT WITH US

Advertisement Banner Advertisement Banner Advertisement Banner
Advertisement Banner Advertisement Banner Advertisement Banner
Advertisement Banner Advertisement Banner Advertisement Banner
Advertisement Banner Advertisement Banner Advertisement Banner

BECOME AN INSIDER

Get Future Healthcare Today Insider news and updates in your inbox.

Strategic Communications Group is a digital media company that helps business-to-business marketers drive customer demand through content marketing, content syndication, and lead identification.

Related Communities

Financial Technology Today
Government Technology Insider
Modern Marketing Today
Retail Technology Insider
Today’s Modern Educator

Quick Links

  • Home – 2021
  • About
  • Contact Us

Become a Sponsor

Future Healthcare Today offers content and advertising sponsorships to leading healthcare solution and service providers. Interested in becoming a sponsor? Contact us!

© 2023 Strategic Communications Group, Inc.
Privacy Policy      |      Terms of Service

No Result
View All Result
  • Home
  • About
  • Payer
  • Provider
  • Pharma & Life Sciences
  • Categories
    • Digital Transformation
    • Telehealth
    • Cybersecurity
    • Patient Experience
    • Clinicians
  • Contact Us