There are two classes of products in the contract management market – a revenue cycle management (RCM) product’s contract component and a standalone contract management application. An RCM component is “good enough to cover the waterfront, but doesn’t have great depth,” said Marc Holland, research director for Health Industry Insights. The general sentiment out in the market today, he said, is the desire for greater capabilities and granularity, which is generally found in standalone applications. With cost-shifting and the rise of self-insurance, transparency and new technologies impacting hospital’s revenue cycle, contract management tools deliver significant ROI. Contract management tools automate processes, review contractual terms and help objectify contract renegotiations.
THREE TRENDS TO WATCH
Marc Holland, research director for Health Industry Insights, identified three trends impacting contract management:
1. Transparency: The call by states, Health and Human Services Dept., CMS and consumers for transparency in cost of procedures is intensifying. Contract management tools enable providers to publish cost with confidence.
2. innovations: The plethora of new services, devices and technologies is flooding the industry. Automating and tracking consumable, billing components for a wide variety of cases arms providers with real data for contract renegotiation.
3. Automation: The rise of high-deductible plans, HSAs and procedures not being covered is forcing providers to determine in an automated fashion actual cost of procedures, coverage and patient liability.
USER REVIEWS
“In a constantly changing healthcare environment, the MediTract solution has helped us decentralize the contract management process by providing tools to those people directly responsible for managing their contracts, while at the same time ensuring centralized access and control.”
Lesson learned: “Gaining control of contracts and business documents was an essential effort that has produced significant ROI, but we underestimated the time commitment needed to collect and organize all the contracts we had spread out over our multi-site locations.
Andrew Nathans, vice president for financial operations, Thomas Jefferson University Hospital.
“Accuro Contract Manager and Contract Modeler is a robust contract management system that has allowed Ardent to increase net revenues through the collections and tracking of underpayments, modeling of contract proposals to more effectively negotiate with managed-care payers, as well as provide more accurate financial information for month end accounting processes.”
Lesson learned: “The hardest part of implementing Accuro Contract Manager is coordinating the numerous departments that need to participate to completely understand how all of the data will flow, then taking the tool and weaving it into facility and business office processes to maximize its usefulness.”
Valerie Woodbury, director of revenue integrity, Ardent Health Services.
Accuro Healthcare Solutions
Accuro Contract Manager
An Internet-based solution designed to accurately forecast, calculate and capture all net revenue contractually owed, helping hospitals manage contract inventories, leverage contract negotiations and simplify the reimbursement process.
Contact: Sales Support, 877.321.0500, solutions@accurohealth.com
Ariba
Ariba Contract Management
For superior enterprise-class contract management, only Ariba offers the speed, sustainability, coverage and flexibility for negotiation cost savings, lower admin/legal costs, reduced regulatory risk and elimination of overpayments/missed discounts, maverick/redundant contracts and missed deliverables with increased supplier/spend performance.
Contact: http://www.ariba.com/company/request_info.cfm, 650.390.1000
Concuity
ClearContracts
Concuity’s Web-based, HFMA Peer Reviewed solution increases revenue and optimizes profitability across the healthcare enterprise. Concuity provides visibility and control to create and negotiate fair contracts, comply with contractual obligations, and identify and recover on underpaid accounts.
Contact: David Rodriguez, 847.941.9230, drodriguez@concuity.com
Emptoris
Emptoris Contract Management
Emptoris Contract Management is the healthcare industry’s most comprehensive contract management solution, providing powerful contract administration, corporate visibility and proven controls that improve the management of provider agreements, dramatically reduce costs and ensure regulatory compliance. Emptoris customers include the industry’s largest healthcare payers representing 40 percent of the covered lives in the U.S.
Contact: 781.993.9212, info@emptoris.com
I-many
I-many Contract Manager
I-many Contract Manager allows organizations to automate the entire contract management continuum from create, store and manage to alerts and notifications on key business events and milestones.
Contact: Charlene Dickey, 800.832.0228, cdickey@imany.com
Kryptiq
Choreo Contract Manager
Choreo Contract Manager is designed specifically for health plans to streamline and simplify provider contract management. Organizations can review and approve contracts, create and view standard reports and administer a variety of other common provider contracting tasks and workflows.
Contact: Matt Koehler, 503.906.6250, mkoehler@kryptiq.com
McKesson
Pathways Contract Management
Pathways Contract Management automates the contracting and reimbursement process, including monitoring payments from payers, updating accounts receivable and performing “what-if” contract modeling analyses across all payers to strengthen contract negotiations. Contract and claim details can also be used for providing estimated out-of-pocket costs.
Contact: McKesson Sales Inquiries, 800.981.8601
MediTract
MediTract
MediTract is the leading contract management service provider helping healthcare professionals regain control of their contracts and reduce the cost of doing business by providing the tools necessary to improve management’s visibility of contractual obligations, enhance compliance and streamline workflow.
Contact: Sales, 877.492.8490, info@meditract.com
Preferred Medical Marketing Corporation (PMMC)
PMMC Contract PRO
PMMC’s solutions deliver quantitative benefits such as low cost, timely installation, improved contract negotiations and high collection recovery results as well as qualitative benefits such as a guarantee to handle all payer reimbursement calculations, superior support services, flexible implementation options, ease of use and user-led enhancements for hospitals and physician groups.
Contact: Greg Kay, senior vice president, 704.543.8103, gregk@pmmconline.com
User Review: "PMMC's client communication is very proactive with continuous feedback on upgrades and enhancements and their monthly user calls are a terrific resource for providing best practice information. PMMC is completely different than other software vendors that after they sell their product, you have trouble reach them again."
Lesson learned: "It would be helpful if there was more standard information on state-specific Medicaid reimbursement methodologies."
Jennifer Winchester, director of managed care, Lexington Medical Center
TPMS
Harvest Contract Management System
Harvest provides key tools for successful revenue cycle management, including 100 percent vendor setup and ongoing maintenance of all payment rules.
(Editor’s note: Accuro Healthcare Solutions announced its acquisition of TPMS on April 8, 2008).