Bundles Modeling & AdministrationCedar Gate is uniquely suited to serve as a shared point of contact and communication among healthcare organizations with 30+ years in bundled payment arrangements. Our platform identifies and develops bundle opportunities to reduce spend and improve quality of care.
Whether you’d prefer a complete, end-to-end outsourced solution or would rather choose from a variety of services to complement your current capabilities, we can help.
Get Started
Use our proprietary platform to ingest your data and easily create customized bundle definitions that will then model a baseline episode experience. During this process our experts conduct an opportunity analysis to prioritize contracting for high-performers and calculate pricing while identifying potential quality targets.
During this phase we work with your organization to align a robust provider network, configure contract terms by line of business and episode, and develop provider-facing documents and baseline reports. Education will be top of mind for implementation and we have all the tools to make this a seamless process.
Our proprietary claims engine consolidates fees into a single bundled claim, then automatically unbundles and distributes payments to providers downstream while managing the risk pool. We also offer services including provider credentialing, network development, provider engagement, payer/provider contracting, patient experience and engagement, and bundled program marketing and expansion.
Monitoring each bundle program and optimizing it for sustainable performance using actionable analytics is key. We refresh data feed quarterly and perform a extensive analysis to determine ROI and progress. Employer and provider self-service portals with customizable reporting allow drill-down performance detail.
Cedar Gate models all 32 BPCI-A bundles and utilizes CMS claims data attributed to our clients to analyze and determine which bundles have the best opportunities, relative to the CMS targets, which providers in our client’s system can best hit those targets, and perform review and reconciliation of financial performance across CMS programs.
Effectively create predefined and custom workflows or “plays” to drive improvements in financial, operational, and clinical performance. Use your pricing, claims, and utilization data to reveal the projected value and potential timetable of a play before you begin. Once you execute a play, then monitor, track, and display performance data, while receiving updated action items to improve performance throughout the year—not just at year-end.
Workforce expectations are on a collision course with economic reality as cost-sharing increases have outpaced employees’ abilities to pay. In order to recruit and retain talent, employers must provide employees with access to excellent care while also managing the cost of providing that care.
Cedar Gate offers an end-to-end solution for Center of Excellence programs that are designed for specialized care and treatment services. When the program is paired with prospective bundles, it allows a single payment to be disbursed to all providers involved. Depending on your specific benefits plan structure, our staff can help determine the best administrative route and provide technology to handle direct-to-employer invoicing or payer involvement.
Contact UsUsing our prioritization model, we configure and select a diversified blend of inpatient, outpatient, and/or blended care settings bundles along care pathways to mitigate program downside risk and increase the program size and market share. Our process ensures that we create win-win solutions for all participating parties, which is key to developing sustainable Centers of Excellence programs.
We know the importance of messaging when launching a Center of Excellence Program. To gain buy-in, the value proposition needs to be clearly communicated to all audiences involved. We are there to support you every step of the way to ensure your success and continuous growth.
Act on emerging opportunities to transform operations and improve financial performance.
Explore
As one of the largest employers in Texas, this company pledged to change the experience for employees…
READ MORE
Transitioning fee-for-service healthcare to value-based care models has not been easy…
READ MORE
The traditional fee-for-service reimbursement model has caused a deep-seated mentality…
READ MORECedar Gate’s enterprise performance management analytics and administration platforms reduce risk, enhance financial performance, and improve patient outcomes for healthcare organizations across the value-based care continuum.
Capture, organize, and utilize all valuable data sets securely and easily.
EXPLOREEmpower your team with timely information to take action and reach performance goals.
EXPLORETransform the way you report on your business with these intelligent tool sets.
EXPLORESupport medical management activities across the care continuum.
EXPLOREManage patients effectively from chronic conditions to transitions of care.
EXPLOREOperate multiple lines of business with claims and benefits administration, eligibility, capitation reconciliation, financial management and more.
EXPLOREExtend your effectiveness with managed, professional, or advisory services.
EXPLORE