This case study explores how a comprehensive cost containment checkup helped a leading health plan identify and prioritize opportunities to improve claims recoveries and savings. By setting out to increase recoveries from 1.4% of total medical expense to 2.0%, this healthcare payer discovered how to add $40 million to their bottom line.
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Instead of attacking cost containment with separate projects, healthcare cost containment expert, Bill Whittemore, discusses the value and advantages of measuring cost containment on an enterprise-wide basis. He then shares specific steps for identifying opportunities to improve results.
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Rather than analyzing cost containment activities as individual programs, health plans should look holistically across these programs to determine their overall effectiveness.
This checklist reviews five key elements every health plan should know about its cost containment and claims recovery programs.
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Health plans are being asked to do more with less – to work smarter and more efficiently across all functions of the organization. Health plans must look enterprise-wide, across dispersed cost containment activities, to measure overall performance so they can identify the best opportunities to advance their goals.