Commercial Payor Reimbursement Benchmarking

For most healthcare organizations 3rd-party, payor and provider are contracting essential elements of an organization’s success.  While negotiating these contracts, the Knowledge of the current range of prevalent market commercial reimbursement rates can make the difference in achieving a successful outcome. Health Capital Consultants (HCC) provides extensive and cost-effective custom analyses of industry normative benchmark data related to the allowable commercial payor reimbursement rates for a variety of client needs, including:

1. Commercial payor contract negotiation;
2. Provider services agreement negotiation;
3. Fee schedule evaluation;
4. New service line development;
5. ACO participation assessment; and,
6. Business plan and proforma planning.

HCC’s healthcare industry commercial payor reimbursement benchmarking analysis are focused on specially targeted services, including:

1. Hospital inpatient and/or outpatient services;
2. Physician specialty-specific;
3. Identification of site of service (i.e., facility and/or non-facility);
4. Detailed to a specific geographical market service area(s); and,
5. Professional services, technical services, and/or global services;

The results of HCC’s healthcare industry commercial payor reimbursement benchmarking analyses may by reported by allowable rate, conversion factor, and/or percentage of medicare reimbursement.  For further information on healthcare industry commercial payor reimbursement benchmarking, please call HCC at 1-800-FYI-VALU (394-8258).