Payment Integrity Standards & Benchmarks | Kisaco Research

Spearheading standards for more affordable healthcare. 

In a system under crisis to reduce costs, benchmarks reveal hidden inefficiencies and enable proactive cost containment. 

Demonstrate a strong National Value Story.  

Showcase the value of PI for clients, measure a national footprint and Blue Card program.

Optimize savings performance. 

Identify new savings opportunities by PI program, inform resource investments, risk mitigation.

PI Benchmarking Participants

8/10
Largest National Health Plans
45+
Health Plans
9/10
Leading Vendors

Collaboration is critical for progress – and momentum is building.

A Working Group of operational and financial PI experts with 200+ combined years of experience are creating standards and benchmarking guidance.

Exclusive insights at MCC conferences including share out of savings PMPM benchmarks, discussions and resources for exceeding standards. 

Kisaco Researchan independent research firm and creator of MCC/HPRI series, is leading the initiative.

 

Standard Definitions & Benchmarking Guidance

To access the Industry Directory of PI Programs (Medical), click below:

VIEW SHEET

To access the Savings PMPM Calculation Deck, click below:

VIEW SLIDES

Process

Get Involved​

What is the latest guidance on how to define Savings PMPM? How do we propose calculating pre-pay savings? Provide feedback through: 

Workgroup

Join monthly calls as you can to provide input on savings PMPM benchmarks and other key initiatives.

Access

Anonymous survey for health plans to share savings metrics in order to access benchmarks.

Resources

Attend MCC Chicago for exclusive access to benchmarking metrics, panel discussions, roundtables, and Workgroup meetings. 

Community

Join the PI Standards & Benchmarks LinkedIn group for updates, discussions, and networking.

Resources