How one rural critical access hospital (CAH) is utilizing data-driven insights to improve reimbursements and close revenue gaps
Claritev’s Provider Strategy and Data Insight Services helped a rural healthcare organization overcome mounting financial pressures, care and access hurdles, competitive disadvantages, and fragmented data systems.
Discover How Claritev’s Provider Strategy and Data Insight Services Transformed a CAH’s Financial Outlook:
Key Challenges:
- Financial Pressures & Administrative Burdens: Rising costs and lagging reimbursement rates strained sustainability.
- Fragmented Data: Disparate payor and vendor data obstructed pricing optimization and made it difficult to benchmark or optimize reimbursement models.
- Competitive Disadvantages: Limited leverage in contract negotiations.
Turning Complexity into Gains:
- Smarter pricing strategies: Identified underpriced services and aligned pricing to market benchmarks.
- Reduced patient care leakage: Pinpointed service gaps in high-revenue areas and recaptured lost revenue through targeted expansions.
- Operational efficiency: Automated pricing simulations, freeing leadership for strategic planning.
- Data-driven negotiations: Entered contract discussions with real-time, benchmarked evidence.
