TOG Launches Medical Economics Division Optimizing Payer Profit Margins
TOG is now the only health care provider network builder with a medical economics division that supports the full network operations life cycle. The division was added to help payers make sound business decisions throughout every phase of the provider network market life cycle.
How Does Medical Economics Impact Your Provider Network?
The dynamic nature of the health care marketplace requires constant monitoring and evaluation. Knowing when to enter a market and at what rates can make the difference between a highly profitable provider network and one that is a costly liability. TOG understands that payers need the assurance of ROI during all phases of the network operations life cycle.
- Pre-network Entrance + Bid Phase: TOG’s medical economics division provides health insurers with solid competitor benchmarking data. This offers payers the confidence to enter a new market with the assurance of predictable profit margins. Staff in this division are also knowledgeable of various payment methodologies across state lines, and such nuances are essential to this process.
- Build Phase: The data from TOG’s medical economics division provides network contract negotiation guardrails, ensuring optimized, market-specific service rates designed to increase profitability.
- Contract Delivery: TOG offers medical economics services to study and reduce delivery costs by closely analyzing expense patterns and trends. Medical economics also assists with the implementation of network steerage along with offering cost containment strategies. From identifying doctors who are prescribing the most expensive drugs to costly procedures where more affordable interventions may exist, TOG is sharply focused on optimizing its clients’ bottom line.
- Rebid Preparations: The dynamic nature of the health care marketplace requires constant monitoring and evaluation. Before rebidding a government-payer contract, it is essential to reassess the provider landscape to ensure the prospect of continued profitability.
TOG’s medical economics services help health insurers make sound business decisions throughout every phase of the provider network market lifecycle. The value of these services translates into a combination of savings and increased profitability that no other health care provider network builder can match.
To learn more about how TOG’s medical economics division serves you, schedule a complimentary consultation today.