Providers Fight Back

With the “death stars” of Amazon/Berkshire Hathaway/JP Morgan, CVS/Aetna and United/Optum moving quickly to disrupt the provider space, it is now more important than ever for providers to have effective tools to fight back………………………..

Key Benefit Administrators and CSuite Solutions Partner to Offer Direct-to-Employer Model for Self-Funded Health Plans

MyHealthGuide Source: NBC, 5/10/2018

Tampa — CSuite Solutions (CSUITE) in partnership with Key Benefit Administrators (KBA) announced the availability of a new provider-sponsored, self-funded healthcare program that was created just for healthcare systems and hospitals to level the playing field with the payors. CSUITE is a healthcare consultancy comprised of former health system provider Presidents and CEOs who are well-known amongst their peers in the industry.

With the “death stars” of Amazon/Berkshire Hathaway/JP Morgan, CVS/Aetna and United/Optum moving quickly to disrupt the provider space, it is now more important than ever for providers to have effective tools to fight back. The new Direct-to-Employer (DTE) program is one of very few offerings that allows healthcare systems to sell their own provider-branded and sponsored health plans to employers with as few as 10 employees or as many as 100,000 plus. This program is NOT insurance and does NOT require a healthcare system to become an insurance company and take on claims risk which we know has been a disaster for a number of very large providers.

DTE does allow health systems and hospitals to work directly with employers WITHOUT an insurance intermediary using KBA’s best-practices legacy of 30 years of successful self-funded healthcare plans to greatly reduce the cost of healthcare for the employers. DTE has 4 active installations currently and will further case studies and peer reviews later in 2018. Direct-to-employer programs are a hot topic in the industry right now but none that provide the tools and proven outcomes that we do. This program is the answer for all providers who are feeling under siege right now.

A recent article published in Becker’s Hospital Review from May 4, 2018 led with the headline: “4 executive insights on the challenges of direct-to-employer models,” and continued, “As hospitals and health systems shift toward value-based reimbursement and look to remain profitable while adapting to what healthcare consumers want, direct-to-employer models are on the rise.

Employers are increasingly frustrated with a lack of transparency into health plans’ premium rates and coverage policies. Furthermore, employees are becoming less satisfied with how services are offered through their health benefit plans. To improve care quality and reduce administrative costs, some employers are fostering direct relationships with medical providers.

Through direct-to-employer contracting strategies, hospitals and health systems can secure direct reimbursements through gain sharing and give medical providers a stronger voice in developing protocols for managing patient cases and care regimens, all while helping employers cut healthcare costs.

However, as medical providers navigate the best ways to put these strategies into action, they face a number of challenges, particularly when exploring price transparency, developing payment models that serve diverse patient populations and jumping over various administrative hurdles.

The DTE program is a direct response to the market and industry needs and aims to solve the current gaps and challenges in the traditional insurance model. If you are interested in learning more about the DTE solution for your health system, area employers and community, visit our contact page to connect with us.

About Key Benefit Administrators
Key Benefit Administrators (KBA) is a nationally recognized employee benefit expert because of our competency in working with complex healthcare administration and risk management. We have developed the oldest and largest database on which a consistently applied patented process of population management techniques has been used by us since 2002. This process is patented by the US Patent Office, and as a result of this patented process, 98% of our customers have experienced a reduction in their healthcare costs in relation to the current medical trend. Visit www.keybenefit.com.

About CSuite Solutions

CSuite Solutions was formed to attract the most senior and accomplished health care industry executives in their respective fields. They have spent most of their long careers transforming hospitals and major health care systems, physician groups and other providers into efficient and financially robust operating organizations. These C-Level executives are now dedicating their talents and connections to helping their peers successfully navigate through these transformative times.  Contact Stewart Schaffer at stewart.schaffer@csuitesolutions.com and visit csuitesolutions.com.

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