SE Healthcare has announced the official rollout of its software platform that would help practices increase revenue through enhanced reimbursement. For this exciting news, we decided to interview Brian Donovan, VP of Business Development at SE Healthcare. 

SE Healthcare has added a new component to the company’s Physician Empowerment Suite, namely, the Reimbursement Effectiveness Platform. Can you tell us more about this platform?

The Reimbursement Effectiveness Platform (RE) is a component of the Physician Empowerment Suiteâ„¢ (PES). The PES is a set of data analytics tools that help practices and healthcare organizations of all sizes to enhance operational performance, mitigate risk, improve reputation, and optimize reimbursement.

The RE tool uses Patient Experience and Clinical Effectiveness data from within the Physician Empowerment Suite™ to develop a “value story” for a practice. It also develops an analysis of payment levels for a practice’s top commercial payers. With this information, a practice becomes well-positioned to drive performance within the practice and engage payers for enhanced fee-for-service and fee-for-value reimbursements.

The RE Platform also provides a library of instructional videos which walk users through a variety of topics. The video library covers topics like:

• The changing landscape of healthcare
• The steps to better leverage for negotiation with payers
• Elements of value-based pay
• How to prepare a Payer Portfolio Analysis and use it to negotiate with payers
• Expert knowledge on reimbursement topics
• How to optimize use of the Physician Empowerment Suite (PES)

How can the Reimbursement Effectiveness Platform complement the other components of the Physician Empowerment Suite?

As mentioned previously, the RE tool uses Patient Experience and Clinical Effectiveness data to develop a “value story” for a practice.  This report helps quantify a healthcare provider’s value to key stakeholders in the market based on various aspects of patient care and practice operations. A report is automatically developed that highlights areas where the organization thrives or needs improvement and shares other supporting performance data.

How can the Reimbursement Effectiveness Platform help healthcare providers increase reimbursement and grow their business?

The Payer Portfolio Analysis, another component of the Reimbursement Effectiveness Platform, is a benchmarking analysis tool that displays payment rates for top commercial payers compared to Medicare and other sources. By highlighting where practices are underpaid, they can create a fee-for-service, payer-specific strategy for top commercial payers. Together with the value story, practices can use this information to drive performance within their practice and engage payers for enhanced fee-for-service and fee-for-value reimbursements.

What types of reimbursements can the Reimbursement Effectiveness Platform handle?

Fee-for-Service, but by leveraging the value story component of the tool, the practice becomes well-positioned to explore opportunities for entering into enhanced fee-for-value arrangements. This creates possible new revenue streams.

Who can use and benefit from the Reimbursement Effectiveness Platform?

All healthcare providers who have fee for service agreements with payers including hospitals, physician practices, and ancillary providers.