We build data-driven solutions for health Payers and Providers that optimize the answer to a key question, asked thousands of times every day, at industrial scale:
On this date, for this Payer and this Provider, for this diagnosis and procedure:
How much should this cost?
Working with the leadership of top health insurers and administrators, MacroHealth initiates and supports the development of competitive strategic advantage.
Our solutions leverage extensive experience in health service purchasing, access to insurance markets, data analytics, technology integration, regulatory compliance, strategic partnerships, and corporate development.
Payment Integrity Optimization Services include:
Independent and confidential analysis of existing medical cost containment infrastructure
Benchmarking existing solution against the market and external datasets
Design of optimized, best-practice cost containment solutions
Negotiation and legal contracting with vendor cost containment companies
Project management of operational and technology implementation of optimized cost containment solution
Ongoing services include:
Vendor management of vendor cost containment companies
Business development support, including medical pricing to support underwriting
Continued analysis of cost containment solution to ensure ongoing optimization against the market
Renegotiation and/or renewal of contract terms with cost containment company or companies
RFP Management and Support
Strategic Development, Corporate Development and Transaction Support