The newfound importance of EMR data in rebate management

May 2, 2023

Since 2016, we’ve been helping healthcare systems manage and optimize rebates. When we engage with a new health system, they seem puzzled about why we need EMR data to manage their rebates. Some health systems will agree, and others tell us to work off their ERP Data alone. While not optimal, we’re still happy to help.

For those people asking, “Why do you need EMR data?” Up until a few months ago, the answer went something like this: “We use EMR data for two main reasons. The 1st is for audibility. We can track rebates all the way down to the procedure. Why that’s important? EMR data ensures we can close the loop between the PO and the procedure.  It is the easiest way to mitigate Vendor/ health system rebate discrepancies.  The 2nd reason is for better facility transparency. The data can show you which facility, physician, and procedure best leverage incentives. It also helps manage minor course corrections if compliance slips in one area or another.” If a health system has incentive arrangements with surgeons, we rank their performance. All reasons are valid to bring transparency and progress to a healthcare system.

The times are a changing

Yet, things are changing. Lately, we’ve seen some rebate clauses that  NEED EMR information to track. Rebates terms stating systems must use specific products in a single procedure. You need to be able to map POs to procedures to ensure you qualify. Without a system that maps rebate terms while merging PO and procedure data, it’s difficult to track this agreement.  

If you’re still using spreadsheets to track rebates, your job is now a lot more difficult. Most health systems know rebates are the best route to value but don’t have the manpower to track them.  Many throw up their hands and try for capitated pricing with varied success. Vendors are doing what they can to use rebates as a pathway to value. It seems the only ‘carrot’ available to get value in price negotiations. Each year, the rebate models get a little more complex.  

In summary, rebates are still good!! Health systems need to take a practical approach to tracking rebates.  With rebate complexity on the rise, this means ditching the spreadsheets for a system.   What would 20% more in rebates mean to your health system? For some, that 20% is a few FTEs a year.  For others, it’s millions more in savings.  Rebates can be a profit center.  We can help when you’re ready.