Payment by Attendance Instead of Enrollment

$250K–$1M per year in aggregate from increased staff handling of attendance exceptions, error-driven over/under-payments, higher provider churn and closures due to volatility, and subsequent need to recruit and onboard replacement providers. • $300K–$2M per year from higher contact center and vendor-management workload, emergency interventions for near-insolvent providers, and the downstream cost of provider attrition that reduces supply and increases pressure to develop costly recruitment or incentive programs.

Benefits Issuance staff and providers manually reconcile attendance logs against authorized units to chase missing revenue, using ad-hoc spreadsheets and notes to track chronic under-attendance and to predict cash shortfalls and repayment risks. • Vendor Relations staff maintain off-system trackers of frequently impacted providers, manually summarize patterns of underpayment and volatility, and craft case-by-case explanations or informal arrangements, often referencing spreadsheets and historical email threads.