Decision Support

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


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, RCC, Volume, DCS (Cost Sum), Ratio of Cost to Actual Charge (RCAC, board markups), Actual Costing 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



Decision Support also provides organizations a methodology to adjust Individual Practitioner 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 unit costs need to be modified to reflect the actual practice costs of the practitioners.

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

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

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

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, service lines, MS-DRGs, procedures or primary care practitioners’ planned levels of cost for each cost-driving process and compare the actual cost to the plan

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
  • Simulates 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


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