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Abridge cost tuning

Skill jeremylongshore/claude-code-plugins-plus-skills/plugins/saas-packs/abridge-pack/skills/abridge-cost-tuning

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Install
npx -y skills add jeremylongshore/claude-code-plugins-plus-skills --skill abridge-cost-tuning

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What its author says it does

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'Optimize Abridge clinical AI costs through tier selection, session management,

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SKILL.md

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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)

FactorImpactOptimization Lever
Provider countPrimary cost driverOnly enroll active providers
EHR depthIntegration complexity premiumStart with basic, upgrade incrementally
Specialty countSome specialties cost morePhase specialty rollout
Session volumeIncluded in per-provider pricingNo per-session cost concern
Patient summariesMay be add-onEnable only for portal-integrated sites
LanguagesIncluded (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

IssueCauseSolution
Usage data unavailableAPI doesn't expose metricsRequest usage reports from Abridge CSM
ROI negativeLow adoptionFocus on provider training before renewal
High waste ratePoor onboardingInvest in provider change management

Resources

Next Steps

For architecture design, see abridge-reference-architecture.

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