What We Do

ContessaCare™

ContessaCare™, our proprietary clinical model, is the result of extensive clinical design centered upon optimizing the site of care for episodes that traditionally require a hospitalization. The success of home hospitalization, and the entire episode, is dependent upon our physician-directed care coordination model.

The elements of care comprise of:

  • Patient Identification

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    Patient Identification

    Determine which patients are eligible and the appropriate site of care

  • Pathway Specific Clinical Protocols

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    Pathway Specific Clinical Protocols

    Customizable protocols by pathway

  • Market-based Care Coordinators

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    Market-based Care Coordinators

    All healthcare is local

  • Virtual Visit Capabilities

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    Virtual Visit Capabilities

    Telehealth kits allow for continuous communication with the patient’s care team and monitoring of vitals

  • Outcomes & Satisfaction Tracking

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    Outcomes & Satisfaction Tracking

    Our partners are provided with all clinical and patient satisfaction outcomes

Bundled Payment Managed Services

Contessa provides the administrative resources for launching and operating a prospective bundled payment program, while minimizing disruptions to our partners’ existing day-to-day operations.

Administrative resources include:

  • Defining Episodes of Care

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    Defining Episodes of Care

    Choose from existing episode definitions or customize for your specific market with assistance from our data analytics technology

  • Network Development

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    Network Development

    Contessa creates the high performing, episodic network needed to manage the episode of care

  • Provider Contracting

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    Provider Contracting

    Contessa contracts with program participants

  • Risk Reinsurance

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    Risk Reinsurance

    Adjust the program to your desired risk-appetite

Our team’s experience with bundled payment initiatives helps our partners identify the inefficiencies and barriers to launching a prospective bundled payment program and address those inefficiencies and barriers by creating the most efficient administrative and technological solutions. Prospective bundled payments is the only manner in which Contessa Health is reimbursed, that makes us the most logical party to manage the revenue cycle related to the program.

The Complexities of Bundled Payments

ContradoClaim®

ContradoClaim® allows our partners to administer prospective bundled payments without disrupting existing claims processing workflows. By interfacing with existing technology, provider and payer partners process claims according to existing workflows, and we manage the rest.

The core functionality consists of:

  • Episode Analytics

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    Episode Analytics

    Detailed review of the cost of care from an episodic perspective

  • Prospective Claims Adjudication

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    Prospective Claims Adjudication

    Operates claims processing and payment of prospective bundled claims for payers and providers

  • Program Analytics & Reporting

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    Program Analytics & Reporting

    Provides program partners insight into cost and utilization across episodes