Maintaining and updating a managed care contracting strategy is essential for any healthcare organization. Successful managed care contracting not only optimizes revenue and limits risk, but could be the catalyst to becoming a profitable organization. With VMG Health’s seasoned healthcare analytics team equipped with comprehensive expertise, clients gain invaluable insights into managed care reimbursement dynamics spanning diverse service lines and service locations. This empowers organizations to make informed, data-driven decisions that are strategic in nature.

VMG Health’s team can help your organization optimize revenue by illuminating inequities in service line rates and payor reimbursements compared to actual collections. Leveraging our expertise, we offer an array of managed care analytics services, encompassing an evaluation of payor contract performance, historical collections analysis, and market reimbursement assessments. These insights serve as pivotal tools in guiding strategic decision-making processes for sustainable growth and profitability.

VMG Health’s Revenue Consulting Offerings

  • Black Box Reimbursement Analysis: Analyses that help shed light on payor contract performance between multiple parties and the related impact on an organization’s top line revenue.
  • Historical Payment Analyses: Developing models that compare historical payments and contracted managed care rates to identify underpayments or other revenue cycle issues.
  • Site of Service Impact: Modeling analyses to provide insight into the revenue impact of shifting a service from a hospital to a freestanding setting.
  • Market Rate Assessment: Benchmarking a provider’s historical payments and managed care rates against market reimbursement data for commercial payors.
  • Payor Contract Negotiation Support: Benchmarking and scenario analysis to help clients assess current contract performance and potential impacts to revenue for any change in contract rates.
  • Customized Reporting: Development of managed care dashboards, KPIs, and data visualization to assist clients with strategic decisions.