The gap between contract and payment.
Reimbursement drift is a specific, findable gap rather than a vague inefficiency. It compounds quietly, contract cycle after contract cycle, until it threatens a service line's viability or an organization's ability to operate. HealthPulse locates that gap and tests it against real evidence before recommending anything.
The chain HealthPulse traces.
Three mechanisms, tested rather than assumed.
A rate exhibit that was never updated after a program or service line changed. The contract still describes an organization that has since moved on.
A single-case agreement negotiated after care had already begun, when it should have been settled first. Timing is the whole of it.
An outlier or stop-loss threshold that no longer reflects the current cost of care, so the mechanism meant to absorb high-cost cases stops absorbing them.
These are mechanisms HealthPulse tests for where they apply. None of them is a claim about any particular organization.
Where does this show up for you?
Drift looks different in a Critical Access Hospital, a CAR-T program and a state agency. Tell us where you sit and what the numbers are doing.
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