abridge-cost-tuning

Installation
SKILL.md

Abridge Cost Tuning

Overview

Abridge pricing is enterprise, sales-led, and per-provider. Cost optimization focuses on maximizing provider adoption (to justify per-provider cost), reducing wasted sessions, and choosing the right tier for your org size.

Pricing Model (Enterprise)

Factor Impact Optimization Lever
Provider count Primary cost driver Only enroll active providers
EHR depth Integration complexity premium Start with basic, upgrade incrementally
Specialty count Some specialties cost more Phase specialty rollout
Session volume Included in per-provider pricing No per-session cost concern
Patient summaries May be add-on Enable only for portal-integrated sites
Languages Included (28+ languages) No incremental cost

Instructions

Step 1: Provider Utilization Tracking

// src/cost/provider-utilization.ts
interface ProviderUsage {
  providerId: string;
  enrolledDate: Date;
  sessionsThisMonth: number;
  lastSessionDate: Date | null;
  adoptionStatus: 'active' | 'low_usage' | 'dormant' | 'never_used';
}

function classifyProviderUsage(provider: ProviderUsage): string {
  if (provider.sessionsThisMonth === 0 && !provider.lastSessionDate) return 'never_used';
  if (provider.sessionsThisMonth === 0) return 'dormant';

  const daysSinceEnrolled = (Date.now() - provider.enrolledDate.getTime()) / 86400000;
  const sessionsPerDay = provider.sessionsThisMonth / Math.min(daysSinceEnrolled, 30);

  if (sessionsPerDay < 1) return 'low_usage';
  return 'active';
}

function generateUtilizationReport(providers: ProviderUsage[]): {
  total: number;
  active: number;
  lowUsage: number;
  dormant: number;
  neverUsed: number;
  wastedLicenseCost: string;
} {
  const classified = providers.map(p => ({ ...p, status: classifyProviderUsage(p) }));

  const active = classified.filter(p => p.status === 'active').length;
  const lowUsage = classified.filter(p => p.status === 'low_usage').length;
  const dormant = classified.filter(p => p.status === 'dormant').length;
  const neverUsed = classified.filter(p => p.status === 'never_used').length;
  const wastedPercent = ((dormant + neverUsed) / providers.length * 100).toFixed(1);

  return {
    total: providers.length,
    active,
    lowUsage,
    dormant,
    neverUsed,
    wastedLicenseCost: `${wastedPercent}% of licenses are unused`,
  };
}

Step 2: Session Waste Detection

// src/cost/session-waste.ts
interface SessionMetrics {
  sessionId: string;
  durationSeconds: number;
  segmentCount: number;
  noteGenerated: boolean;
  noteAccepted: boolean;
  noteEdited: boolean;
}

function detectSessionWaste(sessions: SessionMetrics[]): {
  totalSessions: number;
  wastedSessions: number;
  wasteReasons: Record<string, number>;
} {
  const wasteReasons: Record<string, number> = {
    abandoned: 0,           // Session started but no note generated
    too_short: 0,           // < 30 seconds of content
    rejected: 0,            // Note generated but clinician rejected it
    duplicate: 0,           // Multiple sessions for same encounter
  };

  for (const session of sessions) {
    if (!session.noteGenerated && session.segmentCount > 0) wasteReasons.abandoned++;
    if (session.durationSeconds < 30) wasteReasons.too_short++;
    if (session.noteGenerated && !session.noteAccepted) wasteReasons.rejected++;
  }

  const wastedSessions = Object.values(wasteReasons).reduce((a, b) => a + b, 0);

  return { totalSessions: sessions.length, wastedSessions, wasteReasons };
}

Step 3: ROI Calculator

// src/cost/roi-calculator.ts
interface RoiInputs {
  providerCount: number;
  avgEncountersPerProviderPerDay: number;
  avgMinutesSavedPerEncounter: number;  // Abridge claims 2-3 hours/day savings
  providerHourlyRate: number;           // Loaded cost including benefits
  abridgeAnnualCost: number;            // Total contract value
  workingDaysPerYear: number;
}

function calculateRoi(inputs: RoiInputs): {
  annualTimeSavedHours: number;
  annualLaborSavings: number;
  netSavings: number;
  roiPercent: number;
  paybackMonths: number;
} {
  const dailyMinutesSaved = inputs.avgEncountersPerProviderPerDay * inputs.avgMinutesSavedPerEncounter;
  const annualHoursSaved = (dailyMinutesSaved / 60) * inputs.workingDaysPerYear * inputs.providerCount;
  const annualLaborSavings = annualHoursSaved * inputs.providerHourlyRate;
  const netSavings = annualLaborSavings - inputs.abridgeAnnualCost;
  const roiPercent = (netSavings / inputs.abridgeAnnualCost) * 100;
  const paybackMonths = (inputs.abridgeAnnualCost / annualLaborSavings) * 12;

  return {
    annualTimeSavedHours: Math.round(annualHoursSaved),
    annualLaborSavings: Math.round(annualLaborSavings),
    netSavings: Math.round(netSavings),
    roiPercent: Math.round(roiPercent),
    paybackMonths: Math.round(paybackMonths * 10) / 10,
  };
}

// Example: 50 providers, 15 encounters/day, 5 min saved each, $150/hr loaded
// ROI = significant positive return within first year

Step 4: Cost Optimization Recommendations

// src/cost/recommendations.ts
function generateCostRecommendations(
  utilization: ReturnType<typeof generateUtilizationReport>,
  waste: ReturnType<typeof detectSessionWaste>,
): string[] {
  const recs: string[] = [];

  if (utilization.neverUsed > 0) {
    recs.push(`Remove ${utilization.neverUsed} never-used provider licenses`);
  }
  if (utilization.dormant > 0) {
    recs.push(`Re-engage or remove ${utilization.dormant} dormant providers`);
  }
  if (waste.wasteReasons.abandoned > waste.totalSessions * 0.1) {
    recs.push('Investigate high abandoned session rate — may indicate training gap');
  }
  if (waste.wasteReasons.rejected > waste.totalSessions * 0.2) {
    recs.push('High note rejection rate — review note templates with clinical leads');
  }

  return recs;
}

Output

  • Provider utilization report with waste identification
  • Session waste detection with categorized reasons
  • ROI calculator for contract justification
  • Actionable cost optimization recommendations

Error Handling

Issue Cause Solution
Usage data unavailable API doesn't expose metrics Request usage reports from Abridge CSM
ROI negative Low adoption Focus on provider training before renewal
High waste rate Poor onboarding Invest in provider change management

Resources

Next Steps

For architecture design, see abridge-reference-architecture.

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