Value-based reimbursement models are rapidly gaining prominence as payers look to reward the value, not volume of care delivered. Bundling payments based on episodes of care can help reduce unwarranted variations and more accurately predict medical costs. However, transforming existing Fee-for-Service (FFS) claims into episodic-based payments, can add significant administrative burden and cost.
NetworX Payment Bundling Administration solution enables payers to develop and administer highly automated prospective and retrospective payment-bundling programs that can help improve the cost and quality of care, while enhancing provider experience through efficiencies in reimbursement. The solution integrates with Facets™, QNXT™ and non-TriZetto core administration systems to aggregate and price bundles, and identify quality and efficiency indicators while adjudication occurs.