Costing

Decision Support

To manage costs successfully, you need to have unit costs and resource utilization data at your fingertips

Aggregate

Cost Data

Decision Support Costing solution strengthens your cost development activities by aggregating unit cost data, enabling you to see the entire cost of product lines, populations, contracts, and practitioner groups. You can quickly isolate areas of cost variance, evaluate options for improvement, and focus on monitoring changes and optimizing resources.

Our cost accounting capabilities allow you to:

  • Develop costs at the charge item level using RVU, Volume, Ratio of Cost to Actual Charge (RCAC) and Acquisition Cost methodologies or any combination thereof
  • Create sophisticated overhead allocation models for indirect costs
  • Use fixed and variable cost identification for strategic and financial modelling
  • Develop costs for all provider types
  • Develop claims costs for payers
  • Perform cost analysis and bench-marking

Professional

Costing

Decision Support also provides organizations a methodology to adjust Individual Physician Procedure Cost based upon differences in practice costs. Most often, these adjustment factors will be used to change the cost of activities in a clinic setting, where the RBRVS Standard Values need to be modified to reflect the actual practice costs of the physicians.

Decision Support assists the four major segments of the cost management cycle:

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Structure Definition

  • Identifies all aspects of costs for the enterprise, such as participating entities’ accounting structures, healthcare services bought or sold, member populations, and other cost units
  • Identifies relationships to define revenue flow, expenses for direct/indirect cost determination, and cost aggregation
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Cost Drivers

  • Identifies processes and decisions impacting the cost of services, including practice protocols, new managed care populations, or buying service from outside providers
  • Establishes planned levels of cost for each cost-driving process and compare the actual cost to the plan
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Cost Determination

  • Identifies unit costs for component services delivered by either internal or external providers according to CPT-4, charge code, or other codified patient care service
  • Distributes expenses to cost structures that align the source of expense with the provider services, reflect necessary corporate allocations, and other multi-entity considerations
  • Aggregates costs according to enterprise-wide cost structures, such as contracts, populations, inpatient pathway, or primary care practitioners’ paneed levels of cost for each cost-driving process and compare the actual cost to the plan
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Cost Management

  • Monitors cost performance at all levels of structure, process, or consumer
  • Identifies areas where financial risk needs to be shifted or managed differently due to poor performance
  • Simulate alternatives, such as practice patterns, care delivery setting, contract carve outs, or stop loss clauses, in order to improve performance
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  • Develop and maintain cost standards
  • Allocate actual cost, overhead, and direct, variable, and fixed costs to calculate encounters
  • Run customized “what if” scenarios across your entire organization
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  • Identify episodes, understand profitability and define costs across the care continuum
  • Analyze various episode types, such as transplant cases, re-admissions, and CMS-defined BPCI1 and CJR2 bundles
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  • Integrate all aspects of the payer contract process, including negotiation, contract planning, expected payment calculation, compliance and monitoring
  • Analyze government and non-government payer contracts
  • Conduct robust pricing and reimbursement modelling
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  • Set various budget types, including operating, flex, employee-level, and job code budgets
  • Monitor financial performance trends through embedded workflow and dashboard reporting functionalities
  • Model impact of current and future key decisions
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  • Enable enterprise-wide visibility into everyday financial, clinical and operational impact with advanced dashboards
  • Customize and schedule your desired data to easily spot trends, benchmark results and measure performance

TESTIMONIALS

What People Are Saying

Affinity Decision Support’s drill-down is definitely our favorite feature. It allows for financial management decentralization and cuts down on telephone calls to AP and payroll offices

Katja Waldman

Director of Finance,

Executive and senior level managers consistently find the drill-down functionality in Affinity Decision Support useful and valuable, in some cases, on a daily basis. Affinity Decision Support’s reporting capabilities are the best available on the market.

Masood Peracha

Consultant

We're Here To Help!

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Office

Head Office
2300 Corporate Park Drive
Suite 400
Herndon
VA 20171

Info

info@harrisaffinity.com

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Call Us

(571) 267-3928