Episode Overview:
Around the country, providers are frustrated by the challenges that accompany working through the negotiations and financial reimbursement that come from work with payers. As a result, many providers are considering alternative arrangements such as provider sponsored health plans and direct-to-employer contracts. But developing and moving forward with a new payer strategy requires a long-term commitment and a solid plan — and that’s where provider-sponsored health plan strategies come in.
Today’s provider-sponsored health plan strategies are much different from those in the early 2000s. Now, we’re seeing hospitals working with successful networks that as focused on quality performance outcomes, reducing costs, connect with patients and employers, and decreasing e employer premiums through coordinated health system and employer collaborative efforts. In this episode, host Daniel J. Marino and Clifford Frank, a national expert in managed care contracting and payer strategy, discuss the challenges and opportunities surrounding provider-sponsored health plans.