Payor Solutions: The Payor Challenge
Commercial payors across the country are looking for various ways to better manage high-cost implantable devices. IPG is specifically organized to be a valuable resource, offering comprehensive Implantable Device MangementSM solutions.
There are two critical keys to managing this huge segment:
- Truly understanding device utilization and spend information
- Device Industry Experience & Knowledge
The real key to managing devices begins with gaining a drill down capability, which only comes from being able to isolate information within device claims in a manner that allows all utilization data, costs and reimbursement to be tracked.
In-depth device industry experience cannot be overlooked because there are nuances and details that come with fully understanding the implantable device industry. The team at IPG brings exactly that experience to the table.
WHY THE CURRENT SOLUTIONS DON’T WORK
Without employing IPG's solutions, current methodologies attempt to address this issue by simply wrapping billing and payment for devices into global fee arrangements, but this simply masks the problem and will not give you an effective way to manage implants, because of the following:
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Inability to track the number of implants and keep up with the type of implants being performed…those done in given areas/facilities/physicians/etc.
- Providers and Payors must work together towards a solution that better manages the cost of implants. Acquisition costs vary up to 50% in the marketplace among providers and if we don’t help them manage the cost, it will affect the contracts between the payors and providers.
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Inadequate reimbursement in one setting simply forces procedures into more expensive settings…not a long-term solution.
- Loss of vast other important data that could be integral to better management of devices and recovering otherwise lost savings (ask us about the IPG RECLAIM™ System)