EFuturesCFO · Healthcare Suite
Payer Mix & Reimbursement Analyzer
Model revenue impact of payer mix shifts, Medicare/Medicaid rate changes, commercial contract negotiations, and managed care performance.
Executive Summary
Payer Revenue Breakdown
Reimbursement Levers
Quarterly Revenue Projection
Methodology
FFS Revenue = Encounters × Payer Mix × Rate × (1 + Inflation). Medicare rate adjusted by rate change slider. Blended Rate = Total FFS ÷ Encounters. Managed Care Rev = Lives × PMPM × 12 × Risk Adj Factor. Quality Bonus = Eligible Pool × Quality Bonus %. Shared Savings = VBC Revenue × Shared Savings Rate. Total Revenue All = FFS + Managed Care + Shared Savings + Quality Bonus.