Unlock the Full Value of Your CDM, Set Defensible Prices, and Leverage Transparency Data for Smarter Payer Negotiation
In the evolving landscape of hospital price transparency and reimbursement, strategic pricing and payer contract modeling are related but often disparate and misaligned initiatives. Strategic pricing is typically completed annually based on cost or market analysis with percent-of-charge reimbursement rates. In contrast, price transparency data and payer contract modeling are leveraged during negotiations with payers.
As a result, hospitals and health systems cannot capture the full value of restructuring their CDM, prices, and contracted rates to improve their financial position in the market.
This session will focus on the interplay between setting defensible and optimal prices in the CDM and leveraging transparency data for payer contract modeling, including the various decisions to make, stakeholders involved, and analytical tools needed to succeed.
Session Objectives
- Explore emerging industry trends and regulatory updates reshaping strategic pricing and payer reimbursement, ensuring your organization stays ahead in a dynamic and challenging environment.
- Create enhanced connections between strategic pricing, price transparency, and payer contract modeling to drive informed decision-making and optimize financial performance.
- Master the art of defensible and optimal CDM prices by leveraging market data and payer reimbursement intricacies, including stop-loss and lesser-of clauses.
- Gain valuable insights and leading practices into supply and pharmacy pricing strategies and design effective cost markups that enhance data integrity and profitability.
Meet the Speakers
Moderator
Kevin Chmura
Chief Executive Officer
Panacea Healthcare Solutions
Speaker
Govind Goyal
President, Financial Services
Panacea Healthcare Solutions
Speaker
Brian Prokop
Vice President
Panacea Healthcare Solutions