Case Study
Situation
- Recent staff turnover and growth of clinical costs created need to quickly improve Managed Care insurance payment rates for Long-Term Care business
- Managed Care discussions around Value Based Payment (VBP) required significant financial modeling and strategic assessment to ensure success of VBP program implementation
- Numerous Managed Care plans had outstanding Accounts Receivable (AR) due to client issues and required near-term cash flow relief
SMA Services
Strategic Review
Pricing Optimization
Business Planning
Business Transformation
Actions & Impact
- Reviewed largest patient volume and lowest rates vs. market to target initial plan for improvement discussions
- Modeled current VBP programs and identified potential strategic opportunities to negotiate contract enhancements to improve likelihood of client success
- Created proposals and reviewed with client to position new proposed rate structures and/or contract terms
- Utilized client’s Plan contacts, as well as industry contacts, to position new rate proposals
- Delivered projected revenue improvements with >80% of the Managed Care plans identified meeting or exceeding target market rates
- Negotiated AR improvements and received cash commitments for aging AR