Scaling Value-Based Reimbursement Programs

The time is now to scale your value-based reimbursement programs!

To move your value-based care reimbursement programs from pilot to widespread roll-out, you need automation, flexible, scalable architecture and 360° stakeholder visibility.

What time is it? It’s time to scale and that means it’s time for Edifecs.

Edifecs Population Payment Management, part of our Value-Based Care solution, delivers to health plans, ACOs and other health care entities the fundamental capabilities needed to launch and scale value-based reimbursement programs.

Here’s how we do it:

Target – Identify, and stratify by risk score, specific member populations
Design – Model financial arrangements and design programs through pre-defined templates
Administer – Automate and deliver full transparency of all quality and financial components to all stakeholders
Optimize – Gauge utilization and assess savings opportunities via advanced data analytics

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Meet the Presenters

Fred Guthrie , AVP of Product Management, Edifecs

Fred Guthrie, AVP of Product Management at Edifecs, has been in the healthcare technology space for nearly 30 years, designing, building, and commercializing solutions for organizations including the CDC and national health plans. For most of his career, Fred has been focused primarily on the healthcare payment reform arena, working as a pioneer in the payment bundling space, performing feasibility and ROI studies for healthcare entities, and leading R&D efforts to better enable and scale VBR activities via automation.

Shellie Molina, Staff Product Analyst, Edifecs

Shellie Molina is a Staff Product Analyst for Edifecs’ Value-Based Care solution. An enthusiastic business information technology professional with more than fifteen years’ experience in application development, design and planning, Shellie has extensive expertise in healthcare solution delivery. Shellie has most recently been integrally involved in the full lifecycle of multiple claims and financial solutions, from real-time pricing and adjudication systems, to cutting edge applications for alternative payment model support – including two different episodes of care engines and automation of shared savings management.

Edifecs Inc. is a global healthcare software company committed to improving outcomes, reducing costs, and elevating the value of healthcare for everyone. Edifecs delivers the industry’s premier IT partnership platform to providers, insurers, pharmacy benefit management companies, and other trading partners. By mobilizing its leading solutions at the front end of the healthcare information pipeline, Edifecs provides a unified platform for partners to flexibly pilot and scale new initiatives using their existing enterprise systems. Since 1996, hundreds of healthcare customers have relied on Edifecs partnership solutions to future-proof their leading initiatives in the midst of a dynamic healthcare landscape. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at edifecs.com.

Value-based programs can only bend the cost curve back and have a demonstrable, positive impact on population health when these programs can scale past the pilot / limited-scope phase. Edifecs stands ready as a trusted partner, well-equipped to help efficiently and effectively scale your value-based reimbursement strategies today.