Health plans and their members are paying too much in surgical costs. IPG lower surgical costs to our health plan partners through device management and site of care solutions that are complementary to the plan’s existing clinical cost management, network management and reimbursement programs. Below are solutions and results for our health plan’s key challenges.
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Challenges
Inability to effectively manage surgical costs, with limited impact on device selection or performance of services at high cost settings. -
Solutions
IPG provides solutions to significantly lower implantable device costs; while facilitating site of care shift to more cost-effective facilities. -
Results
Immediate surgical cost savings with multi-year fixed pricing to protect from increases in surgical expense trend. -
Challenges
Current reimbursement methodologies and misaligned incentives hinder health plans from being able to effectively manage surgical care delivery costs. -
Solutions
IPG delivers an easy-to-implement surgical cost management solution that addresses device costs and site of care selection. -
Results
Immediate health plan and member savings based on appropriately aligned incentives that drive lower episodic costs through physician and facility engagement. -
Challenges
Lack of current information that is actionable for the health plan’s network negotiations and ongoing network management. -
Solutions
IPG provides detailed, actionable data to improve the efficiency of your network, identifying device selection and site of care opportunities while also identifying cost efficient, high quality providers to support your overall network strategy. -
Results
Facilitation of optimal device selection and site of care setting and contracting efficiency by allowing new procedures to be performed without the need for facility re-contracting. -
Challenges
Lack of visibility into price variation for similar devices and lack of direct leverage over the manufacturer or device selection. -
Solutions
IPG’s device volume, national scale and contracted manufacturer relationships enable us to secure competitive pricing on existing devices physicians are using while also having direct and priority access to manufacturers to provide clinical training resources and information for surgeons and facilities to take advantage of high quality, lower cost device alternatives through surgeon and facility engagement. -
Results
Lower device costs immediately for implantable devices utilized while achieving further reduction in cost for health plans and members by leveraging IPG’s device selection platform that identifies clinically similar implantable devices to optimize and support better device selection. -
Challenges
25-50% Procedure Cost Variation for the same procedure in the same market among sites of care - (IDNs), independent hospitals and Ambulatory Surgery Centers (ASCs). -
Solutions
IPG, in partnership with health plan network management, analyzes and identifies top facilities, procedures and surgeons with the greatest shift potential and understands and alleviates all barriers to shift – (e.g. reimbursement, surgeon recruitment, cash outlay for the facility, equipment etc.). -
Results
Active site of care shift of surgical procedures to best value location.
TESTIMONIALS
“We needed a strategy to focus on maximizing patient value through the alignment of clinically appropriate surgical services at the most cost-effective site of care. This approach helped us stabilize our premium trend and lowered our out-of-pocket expenses for our members, all while maintaining clinical quality.”
– Director of Network Contracting and Strategic Development
(Health Plan Partner)