Industry benchmarks to measure the impact of payment integrity currently don't exist, making it challenging to optimize performance and areas of opportunity. Standards are extremely complicated due to varied member populations and an inconsistent approach to calculating metrics.
In this groundbreaking panel discussion, learn how a Working Group of payer and vendor SMEs have been collaborating over the last six months to develop a standard approach to calculating savings PMPM across LOB and audit programs. This session will share standard definitions and calculations, so attendees can understand how to calculate and compare their savings PMPM.
Learning Objectives:
- Learn about standard definitions and calculations for savings PMPM that apply to any type of plan, across LOB, region, and program audit
- Understand how to develop savings PMPM metrics that are comparable to a standard industry range
- Provide feedback on the approach to ensure benchmarks are applicable to your organization
- Access resources and expert guidance to support development of benchmarks
Session Topics:
Payment Integrity
Session Type:
General Session (Presentation)