About

SCALE Payer Strategy

SCALE Payer Strategy provides broad Scale Healthcare landscape analysis and identifies opportunities in healthcare across the country, offering integral and insightful research to make the most informed investment decisions.

We combine experience as C-Suite executives for healthcare companies with decades of experience working with and for payers and state and federal government to produce best in class research for our clients. 

Our work produces analysis of competition, potential patient/client opportunity, employers, population forecast, payers, regulatory, and legislation. Clients can utilize our services when interested in expanding into certain targeted states or regions of the country while examining potential acquisitions.

SCALE Payer Strategy is headquartered in North Carolina.

CASE STUDY:

Payer Strategy - Pediatrics

Client Profile

Location
10 + Locations
Specialty
Pediatric

Our Client is a leading independent children’s home health care agency for complex pediatric patients. The business has long-standing relationships with payers often seen solely as a DME provider, even though services are far more extensive.

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What Our Client Partners Say

Collaborating with Scale Healthcare is a refreshing experience unlike engagements with other consulting firms. The members of the team work shoulder to shoulder with you, solving complex issues and overcoming resistant obstacles. They seek to truly understand your service, your clients, and the world in which you operate. Scale's expertise in alternate care models and ability to apply to our unique service offering and pediatric population was equally as impressive as their shared passion for the children we serve.”
Cameo Zehnder, JDChief Administrative Officer Pediatric Home Service (PHS)

SCALE Payer Strategy benefits from the extensive collective experience of our seasoned team of healthcare operators, leaders, and executives, providing our clients with an exclusive insider's perspective on the challenges and opportunities healthcare businesses face across the spectrum.

The SCALE Difference

We utilize our extensive national network to give our clients an accurate outlook and overview before deploying capital and making acquisitions in targeted regions.

Payer Research

Payers can vastly differ per state despite being under the same company. Our understanding of how payers work in each state gives our clients an accurate understanding of the opportunities and challenges from payers when forming a strategy.

Employers

Employers and employer sponsored health plans can drive growth in a healthcare market and create significant opportunities. We identify partnerships with employers for our clients and project the employer’s effect on the market.

Competitive Analysis

Knowing your competition, their services, and targeted patient/client population allows for greater ability to adapt to changes in the market and strategize for future.

Data and Analytics

Scale utilizes commercial payer data from over 100 million covered lives, employer sponsored plans, and published state and federal reimbursement data. We combine our analysis of the data with interviews and surveys to give our clients a very well rounded view of the market.

Patient / Client Opportunities

We combine use of data with surveys and interviews to estimate opportunities with the current patient population and likely future growth.

Regulation / Policy / Legislation

Government regulations and legislation can be a obstacle to account for in the future but also create opportunities in the market. Our deep experience with the government allows Scale to give an accurate view of the current environment and likely future actions.

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Download our one-page fact sheet to learn more about SCALE Payer Strategy solutions.

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