Predicted shifts in payor mix with the help of a scenario analyzer for a leading pharmaceutical company


The client’s managed care partnership strategies, rebates and reimbursement policies are constantly evolving in response to changes in market dynamics. The increased focus on specialty products and biologics add to complex payment rates and contracts. As a result, visibility into payor performance is hampered. The client wanted an integrated source of information.


We took a four-phased approach to this challenge:

  • We ?rst de?ned the business problem by creating a framework, complete with key questions and hypotheses; these were then prioritized
  • We then studied the range of available datasets, evaluating the applicability and applying appropriate business rules
  • Basis step 2, an analytical model was created for segmenting the payor universe
  • Appropriate forecasting techniques were applied and response models were built at the product/payor level to gauge the impact of shortlisted factors on the mix

Key Benefits

  • We were able to generate recommendations for each product in the portfolio based on the impact of signi?cant internal and external factors
  • Our solution enabled the client to build various ‘what-if’ scenarios, providing a prescriptive direction when creating payor mix for the future


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Analyze the entire payor situation and simulate scenarios to enable decisions on the right payor mix

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Create contingency plans for any unforeseen circumstance with any major payor

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Strategize more effectively in near real time and make data-backed business decision

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