McKesson debuts new value-based reimbursement tool

In the wake of health plans transitioning from broad networks and straightforward reimbursement approaches to narrow networks and alternative payment methods, McKesson Health Solutions introduced a new pricing tool Tuesday called "Reimbursement Manager 3.0."

The solution from the Massachusetts-based health care services and information technology company automates network pricing strategies to allow for value-based repayments.

McKesson Reimbursement Manager 3.0 provides health plans with the flexibility to develop their own payment methodologies as well as the ability to determine contract amounts based on numerous factors, such as claim- and- non-claim-related data elements. The latter can enhance a plan's ability to innovate around risk-based payments.

Additionally, the reimbursement tool shows how the price of a contract is calculated and gives insurers the information they need to ensure that claims are being paid correctly in audits.

Michael Flanagan, vice president of reimbursement solutions at McKesson Health Solutions, said the new reimbursement tool addresses the challenges customers are facing at leading health plans.

“At the end of the day, it comes down to understanding the elements of transitioning from fee-for-service to value-based approaches for reimbursement, and the daunting complexity of that transition," Flanagan said. "With McKesson Reimbursement Manager 3.0, we’re giving payers the first next-generation pricer that works intuitively for all the key stakeholders. And that can help assure everyone that claims will be paid as promised in the contract, no matter how complex they might be.”