Historical approaches to cost savings in health care have largely been at the expense of providers and have essentially left the providers out. Worse still, providers and employers have been painted by insurers and third-party administrators as adversaries. Ironically, when providers and employers work together the end result is a more cost-effective health plan that delivers better care to the employees.
Often, the services package that providers put together for employers is insufficient because its implementation is sporadic and its components have limited effectiveness. Providers need to re-position themselves as part of the solution and not continue to be viewed as part of the problem. Improving the health of an employer’s plan members is the best way to achieve long-term, significant savings in health care costs; it’s also the best way to increase the providers’ revenues from that employer’s health plan.
The most efficient health system service package for employers should be a combination of provider skin-in-the-game, clinical targets, quality measures, member satisfaction and assistance in achieving cost controls.
There are many ways to go about accomplishing these goals and Managed Care Partners can help. First, providers must select the appropriate risk sharing mechanisms and develop proper offers to share with employers. We can design an offer for you and assist when you bring the offer to an employer. When the time comes, we can participate in pre-contract and post-contract employer meetings and in drafting the employer contracts.
Second, Managed Care Partners can analyze and calculate fixed rates and/or bundled payment prices. Providers must understand the financial component of any offer and how it compares to current agreements.
Additionally, Managed Care Partners can organize and attend Health & Productivity Team meetings and monitor any employer/provider risk and performance metrics. We also can monitor monthly claims and other reports and utilize data mining tools that are available through the employers’ claims administrators. We can communicate the employers’ and the program’s objectives to the providers and counsel employers on effective plan designs that are aligned with contractual and corporate objectives.
If you are interested in learning more about creating a service package for an employer that will help you build market share, contact Managed Care Partners today.