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