As a provider in the market, we are often seeking innovative ways to deliver care. Many innovations are developed by the frontliners of patient care, but those on the other side of healthcare have the know-how that can lead to innovative solutions that improve the business of healthcare.
"In healthcare …traditionally administrators have looked to the clinical side for innovation but in this value-based space, there is knowledge in the administrative side that holds value as well… processes that eliminate administrative burden… that is where the intellectual property of the administrative side can be found." – Monica Deadwiler, Senior Director, Payment Innovation
In this new era of healthcare, quality measurements, efficiency and good health outcomes achievement led to an idea being born before there was even a market. It all started with a simple statement – we cannot administer bundled payment contracts manually. Prior to the invention, contracts for bundled payment initiatives were calculated manually and that is not helpful if you want to scale any of these programs – there has to be a way to automate this process.
The goal – Bundled Payment Management System.
It was no secret to the inventors, at the same time they were thinking through how to complete the goal, the Affordable Care Act was being rolled out, which was leading to heavy discussions about ACOs, bundled payments, and other alternative payment models. Given the directive, they sought out to find a solution to assist with bundle payment modeling, contract management, claims adjudication, payment distribution and reporting but they couldn't find anything in the market. So they went on a hunt for a partner to help them complete the goal.
As with any development process, there were many starts and stops. The initial concept was everything any organization needed to assist with bundled payments but the platform was very cumbersome. The inventors figured, no one would probably use it. Determined to keep at it, and knowing there was a significant need for such a technology in the market – the re-write occurred. They re-architected the technology to provide a platform that would interface well with the end-users they knew needed the solution the most. The final product – a technology that is adaptable to other providers and health plans and can be leveraged for growth in other areas.