Controlling surgical costs in today’s healthcare environment is a bigger challenge than ever. Price fluctuations, rising facility fees, and unclear billing practices all contribute to spending that seems to only move in one direction—up. In fact, facility costs alone have risen to account for 40% of all workers’ compensation medical expenditures.*
Based on decades of data and industry experience, Paradigm delivers focused solutions proven to mitigate unnecessary expenses. With true cost transparency, our expert-managed platform is built for durable and defensible cost savings.
* Source: NCCI data
As surgical implant technology has grown more complex, managing costs has become increasingly difficult. Paradigm’s Surgical Implant Cost Management solution leverages our proprietary cost containment platform—Fusion by ParadigmSM. The result is that our intelligent, data-driven systems bring pricing objectivity and transparency to surgical implant devices. We rigorously evaluate each case for fair and reasonable implant reimbursement, backed by full defensibility.
69%
average savings across all implant categories
Source: Boston Strategic Partners, 2020
98%
of savings value is upheld through appeal
25
percentage points greater cost savings than other solutions
Source: Boston Strategic Partners, 2020
We cover:
Surgical Cost Management Plus expands the capabilities of our proven Surgical Implant Cost Management program—by tapping into our extensive provider network to identify class-leading savings.
Through an expert-backed process, we review every line of a surgical bill, finding cost reductions across every implant category and optimal network discounts for facilities below fee schedule and Usual, Customary, & Reasonable (UCR) reimbursement.
As costs continue to rise, Surgical Cost Management Plus delivers reduced administrative burden, fewer reconsiderations, and proven reductions in spend.
Download our eBook for guidance on managing rising implant costs.
Our team has first-hand operating room experience as well as surgical implant supply chain expertise, and to date, they’ve reviewed more than 200,000 implant cases totaling charges of more than $2 billion.
An independent study conducted by Boston Strategic Partners found our implant program delivered an average savings of 69%, compared to typical industry outcomes. And our program delivers defensible savings: 98% of Paradigm savings are upheld after any appeal and 88% of total bills remain undisputed.
We have more than 52,000 surgically implantable items in our Fusion by ParadigmSM platform, and it’s updated daily with the latest aggregated, geo-specific cost data, including new FDA approvals and device uses.
In contrast to AI-driven self-service platforms, we fully manage the bill review process providing maximum savings backed by our team’s extensive expertise. And our open and clear communication minimizes the administrative burden on your claims professionals.
