AskMariaTodd™ is a multidisciplinary consultancy that works with health care providers and payers to develop, implement and negotiate innovative cost containment strategies that benefit ASCs, payers and patients. One very effective strategy involves value-based payment initiatives for ERISA employers, Taft-Hartley Plans sponsored by Unions and the commercial and government payer markets – that of bundled payment contracting.

Maria has led the nation with strategic, operational and contract negotiation guidance on bundled price logic and bundled payment methodology specific to ASCs since the mid-1990s. Over time, she has been continually refining and improving her tactics, strategies and modeling to the point where she has positioned several ASC clients for success with commercial payer and direct-with-employer contracting. 

Maria has added to her armament by developing the first and only bundled payment price integrity software in the world that helps providers set bundled prices while integrating failsafes for financial and quality risk mitigation mechanisms. 

Seek her assistance with the following challenges and initiatives:

• pricing models
• payer contract form agreements
• exhibit and attachment templates for:
  • price quotes
  • defined episodes of care inclusions and exclusions
  • payment terms
  • clean bundled claim exhibits and narrative descriptions
• program operation manuals
• program infrastructure
• marketing, and
• promotional activities and events
• social media marketing content

With more than 25 years of experience negotiating bundled payment contracts for surgery procedures, Maria guides your ASC on a service line and procedure-by-procedure basis. Ask Maria for help with feasibility and case rate modeling to negotiating physician alignment with bundled case rate subcontracting for both surgeon and anesthesia professionals. If you want a neutral in your corner with no commission agreements or other back door incentives on procurement or purchasing of technologies, supplies and implants – ask for her advice on how to negotiate the best possible deals. As a former administrator, she can squeeze 7 cents out of a nickel!   And when it comes to contracting directly with TPAs and employers and unions under bundled price programs, she’s reviewed and negotiated or declined more than 60 deals and opportunities nationwide.  With Maria, your risk is mitigated and you don’t have to jump in with both feet at the beginning and you don’t have to tackle every procedure you offer from the start. She’ll help you set a pace that you can manage and put your best foot forward and excel.

Program Evolution to Include Medical Travel

Maria builds programs that succeed and grow. One means by which they grow is market expansion. Often, the programming involved with bundled payment agreements evolves into domestic medical travel. This is the case with both consumers attracted to a cash pay program and to employers and unions seeking deeper discounts. 

As a leading national (and international) expert and published author of several of the best-selling business development books on medical tourism programming and operations she builds out the entire workflow to facilitate:

1. patient movement
2. payment acceleration
3. partner relationships with qualified and appropriate hotels, airport pick up and drop off service providers, food and beverage catering and grocery and pharmacy delivery outlets. 

If you were thinking it was simple, quick, or that medical tourism business development is limited to making appointments for consults from people from out of town or out of area, you couldn’t be more misinformed.  

Medical travel, should you decide to pursue it, is far more complicated than establishing a bundled price and making appointments. Failure rates for those who stop at those points and “call it good” fail to realize ANY traction more than 99% of the time. You cannot simply create and publish a new web page as an afterthought and hope people find it.  Many SEO consultants and PPC consultants have no clue how to promote medical tourism so most US provider programs end up overlooked, never discovered, or under-explained.  

There are numerous healthcare, IRS, FTC, banking, and other compliance regulations you must uphold along with billing and payment issues to make your program work. A  trial and error approach “might” get you there… or it could make serious problems that weren’t expecting, but why risk it when you can be assured of success with a proven road map and tools to succeed?

Infrastructure elements can be easily managed, priced and bundled into custom-tailored bundled payment agreements for consumers and third-party payors. Maria brings you the pre-built templates, checklists and other tools and methods for structuring the plan, identifying ideal partners and securing the agreements to drive incremental commercial volume to your facility, surgeons and anesthesiology team.  No matter what federal price transparency initiatives are promulgated and finalized, you’ll be ready, willing and able to compete, thrive and grow incremental patient volumes and program revenues independent of Medicare, Medicaid, TriCare, and your HMO and PPO payer business. 

Building ASC Brand Recognition and Reputation

Contact AskMariaTodd™ today and get the advice you need for your facility and ask for references, too!