SOLVE IMPERATIVE
HEALTHCARE CHALLENGES

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$0 BILLION

ANNUAL SURGICAL SPEND

(with a 600% utilization increase by 2030)

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Programs that support achievement of Cost of Care Savings Goals

Reduce surgical and implant costs through a medical expense management program with no administrative costs that provides transparency and capabilities to achieve cost of care savings goals and manage the drivers of medical expenses and utilization risk exposure, all while maintaining quality.

Ensuring most affordable, high quality site of service

Implement a proactive process where available procedures are performed in the appropriate setting, subsequently driving a more cost effective solution and alleviating suboptimal sites of service costs and dramatic differences in cost of care between settings and providers.

Driving the shift to value based payment

Realign incentives and integrate performance-based metrics into contracts to ensure the ability to manage to value based performance and reimbursement strategies while incorporating data into Quality Improvement, Narrow Network, Pay for Performance and other Contracting Strategies.

Lowering member healthcare costs

The move to consumer-driven health care is real and here to stay. Implement solutions designed to align care with employer groups, health care providers, manufacturers and other stakeholders who are also striving to achieve high quality and cost effective care delivery, in order to provide the best and most cost effective member experience.

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Exposure to significant trend increases

Mitigate exposure to annual medical trend inflation due to rising costs of care and normalize costs that traditionally have dramatic inconsistencies in implantable device and procedure pricing.

Unknown risk and exposure under the Accountable Care Act (ACA)

Build predictability and controls to mitigate risk against an unknown patient population under the ACA and eliminate exposure to increased procedure inflation due to the demographic shift and baby boomer impact.

Mitigating issues of overpayment

Incorporate technical expertise into the claims review process at a device and part level to ensure adherence to medical policy and avoid costs associated with inappropriate coding and billing.

Infrastructure to support bundled and alternate reimbursement models

Implement collaborative and customizable solutions to support varying provider contracting approaches to ensure care is performed in the most appropriate setting at the optimal cost and quality.

Programs that support achievement of Cost of Care Savings Goals

Reduce surgical and implant costs through a medical expense management program with no administrative costs that provides transparency and capabilities to achieve cost of care savings goals and manage the drivers of medical expenses and utilization risk exposure, all while maintaining quality.

Ensuring most affordable, high quality site of service

Implement a proactive process where available procedures are performed in the appropriate setting, subsequently driving a more cost effective solution and alleviating suboptimal sites of service costs and dramatic differences in cost of care between settings and providers.

Driving the shift to value based payment

Realign incentives and integrate performance-based metrics into contracts to ensure the ability to manage to value based performance and reimbursement strategies while incorporating data into Quality Improvement, Narrow Network, Pay for Performance and other Contracting Strategies.

Lowering member healthcare costs

The move to consumer-driven health care is real and here to stay. Implement solutions designed to align care with employer groups, health care providers, manufacturers and other stakeholders who are also striving to achieve high quality and cost effective care delivery, in order to provide the best and most cost effective member experience.

Exposure to significant trend increases

Mitigate exposure to annual medical trend inflation due to rising costs of care and normalize costs that traditionally have dramatic inconsistencies in implantable device and procedure pricing.

Unknown risk and exposure under the Accountable Care Act (ACA)

Build predictability and controls to mitigate risk against an unknown patient population under the ACA and eliminate exposure to increased procedure inflation due to the demographic shift and baby boomer impact.

Mitigating issues of overpayment

Incorporate technical expertise into the claims review process at a device and part level to ensure adherence to medical policy and avoid costs associated with inappropriate coding and billing.

Infrastructure to support bundled and alternate reimbursement models

Implement collaborative and customizable solutions to support varying provider contracting approaches to ensure care is performed in the most appropriate setting at the optimal cost and quality.

The overarching challenge, which all of IPG’s solutions address is the issue of managing and reducing Surgical and Implantable Procedure Costs. We understand health plans are focused on managing these costs before, during and after care is delivered and we have solutions for every step of the way.