AMPS Reports Record Growth In 2019

AMPS saw significant growth in its large customer portfolio this year, including customers with upwards of 150,000 members. The growth from small to midsize to large customers reflects broad embrace by employers and health systems……………..

MyHealthGuide Source: Advanced Medical Pricing Solutions (AMPS) via P&T Community, 10/1/2019

ATLANTA — Advanced Medical Pricing Solutions (AMPS) announced that 2019 was a year of aggressive, if behind-the-scenes, growth for the company. Under the leadership of Kirk Fallbacher  AMPS CEO and President, the pioneer in cost containment has stayed singularly focused on building out the infrastructure and products to meet the explosive growth of self-insured health plans and the need to contain and control costs.

Self-insured plans now cover 94 million of the 156 million employees—over 60%–who get their health coverage through their employer.

“Almost 100 million employees covered through self-insured plans not only represents a staggeringly large market for healthcare cost containment, it is an extraordinary opportunity for America to meaningfully reduce our national healthcare bill. That’s why AMPS has spent the past year accomplishing big things to service the self-insured market for cost-containment,” said Fallbacher.

He added, “The list of accomplishments includes doubling our headcount, expanding our footprint with a second office in Phoenix, Arizona, launching a comprehensive cost containment solution suite, and acquiring Inventavis, a market leader in strategic health system consulting.”

Over $1 Billion in Reviewed Claims Builds Complete Cost Containment Portfolio

As one of the earliest companies to offer medical bill review and reference-based pricing, AMPS recently passed a major milestone in its 15 years in business. The company has now reviewed over $1 billion in medical claims, substantially reducing the vast majority of them through medical bill review and then pre-care and post-care pricing approaches.

This intensive work, led by some of the industry’s most experienced cost containment experts and a staff of 25 board-certified, practicing physicians, is the foundation of the company’s newly launched All In One solution suite, which includes:

  • “Fair for All” pricing for the employer and provider, utilizing AMPS proprietary technology and pricing data to calculate prices both pre-care and post-care.
  • Member advocacy and education that, unlike conventional health insurance plans, results in less than 5% of members ever having a billing issue.
  • Care navigation that guides members to quality care offered by a large panel of providers that appreciate fair and reliable pricing.
  • Plan performance insights and visibility through on-demand data and dashboards.

“We’ve designed our All In One solution suite to give self-insured employers flexibility in how they add cost containment to their health Plans. Some employers, for example, may want to only focus on repricing claims for procedures that have already taken place, especially high dollar hospital claims. Other employers want to have prices negotiated prior to care, while still other employers want both pre-care and post-care pricing to get the full benefits of cost-containment. We can meet the employer wherever they’re at,” Fallbacher said.

He added, “No matter which approach employers choose, they will benefit from the local and national provider relationships AMPS has built. We see very little ‘push back’ on AMPS price negotiations, which is attributed to the company’s years of expertise and medical bill reviews by our own staff of physicians.”

New Customers Drive Capacity Expansion

AMPS saw significant growth in its large customer portfolio this year, including customers with upwards of 150,000 members. The growth from small to midsize to large customers reflects broad embrace by employers and health systems in the AMPS “fair for all” pricing methodology.

To accommodate this growth, AMPS has opened a second office in Phoenix, Arizona; doubled staff; and expanded the senior leadership team with experienced talent in Operations, Finance, Product Solutions, and Account Management. Overseeing this growth is Fallbacher, who joined AMPS as COO in 2016 and became CEO last year to steer the venerable company to the industry-leading position for innovative, technology-enabled cost containment.

Key Acquisition of Health Plan Administration Company

AMPS also recently completed its acquisition of Inventavis, a leading strategic consulting company founded by industry luminary Larry Thompson. The company’s focus on self-insured employers, health systems and TPAS aligns with and adds to AMPS portfolio of “fair for all” solutions and capabilities. More details about the acquisition will be announced by AMPS in coming days.

Vice Chairman and Founder Tom Castleberry stated, “The AMPS board of directors could not be more pleased with the company’s tremendous momentum under Kirk’s leadership and through the stellar team he has assembled. The company is perfectly positioned to provide healthcare cost containment to the unprecedented number of employers who want to get in on the concept of predictable healthcare prices that reduce cost and increase quality and transparency.”

About AMPS

Advanced Medical Pricing Solutions (AMPS) provides market leading healthcare cost containment services for self-funded employers, public entities, brokers, TPAs, and reinsurers. AMPS mission is to help clients attain their goals of reducing healthcare costs while keeping members satisfied with quality healthcare benefits. AMPS leverages 15 years of experience in auditing and pricing medical claims to deliver “fair for all” pricing both pre-care and post-care. AMPS offers innovative dashboards and analytics to provide clients with insights based on Plan performance. Contact John Powers at JPowers@advancedpricing.com and visit www.advancedpricing.com.

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