hMetrix

Members of hMetrix' senior team average more than 20 years of experience in the development and implementation of data driven payments systems. These include inpatient prospective payment systems, outpatient payment systems based upon Ambulatory Payment Classification (APC) groups or other methodologies, and Resource Based Relative Value System (RBRVS) or other appropriate payment systems for physician services.

What about rewarding providers based on the ultimate goal - best performance?

hMetrix industry experts have assisted in the development of many advanced pay-for-performance models designed to reward best practices.

Our pay-for-performance systems can focus on both facilities and providers, including primary care and specialty providers. We develop systems based on quality-related factors or resource-based results. To ensure optimal results, hMetrix enhances its pay-for-performance models by incorporating risk-adjusted analysis methodologies.

Interested in moving to a forward-thinking, incentive based payment system that coordinates key provider interests? hMetrix has modeled an aligned hospital/physician incentive payment system for a complex statewide program. The system is based on analysis of physician-specific peer comparison actual savings within a DRG.

hMetrix can help your organization structure state-of-the-art performance-based provider payment systems using your own data, appropriate comparative data, or a combination. hMetrix capabilities in this area include the ability to drill down through the data to physician-specific ordering patterns within a DRG.

We also have extensive experience with direct provider contracting, as well as capitation risk model designs, the development of capitation rates, and the management of capitation based payment systems. Depending upon client requirements, hMetrix is also able to apply risk adjustment and predictive modeling to the core reimbursement analysis systems.

Learn more about how hMetrix is helping companies like yours improve provider contracting and how you can benefit too.