DGA Partners helps providers and managed care organizations in payer-provider contract development, with advice based on extensive experience, detailed data preparation and analysis.
To achieve success with payment systems that share risk and align provider and payer incentives you need detailed data preparation and analysis, deep understanding of clinical and financial issues and extensive preparation for contract negotiations. DGA Partners brings to this work our extensive domain knowledge and strategic perspective, and our significant technical skills in data analysis and management.
We're able to assess what emerging payment systems will mean for payers and providers of all kinds. We understand the relationship of payment systems and information technology. We mine large sets of complex data to develop a solid understanding of each client's contracting issues.
DGA Partners can help structure and negotiate a new contract or restructure an existing one to achieve the benefits of aligned interests. Our team can:
- Analyze contract terms, assess financial performance and evaluate utilization vs. norms
- Determine whether a new payment methodology, e.g. pay-for-performance, is budget neutral
- Analyze the potential effect of severity adjustments on reimbursement
- Evaluate physician fee schedules and advise on contracting strategies
- Design data-driven performance analyses to support the distribution of bonus pools
- Help to evaluate which quality metrics and ranking systems will make a "P4P" contract most beneficial for all parties, and develop data management processes for the required data.
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