DME/O&P Spend Optimization

Meaningful spend. Significant opportunity.

DME/O&P represents a meaningful area of healthcare spend—and one of the more operationally complex service lines to manage effectively. Successful delivery requires close coordination among the health plan, ordering provider, DME/O&P vendor, and patient, creating multiple points where cost, service, and access can be influenced.

ARCLYFT Health brings deep clinical, operational, and payer expertise to help healthcare organizations navigate that complexity. From vendor performance and contract analysis to utilization, SLA adherence, service standards, and network strategy, we identify opportunities to optimize DME spend and reduce administrative burden while improving accountability, service delivery, and the patient experience.

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ARCLYFT Helps Organizations Better Manage the Entire DME/O&P Service Line

  • Identify utilization patterns traditional claims audits may miss — including coding variation, frequency and replacement-cycle issues, and inconsistent authorization patterns. We are also available for direct, case-level review of complex O&P prior authorizations and claims that require real clinical judgment, not just a policy citation.

  • Know what your DME/O&P vendor network can actually deliver — not just what's credentialed on paper. True SLA feasibility, staffing ratios relative to volume, appropriate use of care extenders, and rate review, grounded in direct clinical and operational experience across O&P, diabetes, respiratory, oxygen, sleep, and compression therapy.

  • Rate and structure strategy built specifically for the DME/O&P category — capitated vs. fee-for-service modeling, rate-setting, and contract performance review, grounded in the real clinical and operational economics of each category.

  • Peer-to-peer clinical policy support on medical necessity criteria and complex O&P authorizations — from a practicing, board-certified prosthetist and orthotist, not a non-clinical consultant.

  • Advisory support for DME/O&P program design, workflow improvement, and growth initiatives — including new market entry, service line expansion, and M&A-related planning.

DME/O&P Product Category Expertise

From Opportunity to Implementation

Discovery

We start by understanding the opportunity—your current DME/O&P program, vendor relationships, utilization trends, operational challenges, and the outcomes you're trying to achieve.

Analysis

We evaluate the relevant data, workflows, contracts, vendor performance, utilization patterns, and clinical or operational policies to identify meaningful opportunities for improvement.

Findings & Recommendations

You receive practical, prioritized recommendations focused on measurable impact—from utilization and vendor performance to contracting, workflow, and program strategy.

Implementation & Support

ARCLYFT Health can help translate recommendations into action, support implementation, measure progress, and provide ongoing advisory support as your needs evolve.

Let's Talk About Your DME & O&P Strategy

Whether you're evaluating rising spend, utilization, vendor performance, contracting, or a broader DME/O&P initiative, let's start with a conversation about where ARCLYFT Health can help.