Happy Hour Outline of The Lisa Plan
The Lisa Plan is the future of healthcare financing. It makes sense for all the right reasons. Providers win, patients win, and employers who fund all of this win too.
Providers are paid in full at the time of service. No claims to file, no chasing member responsibility and never a balance billing issue.
Central to the strategy is a partnership between select primary care physicians and local employers – a PCP and cash centric health plan.
Traditional managed care plans (PPO) pay providers more than what providers will take for cash. And that of course is reflected in what we all pay for health insurance these days.
There is a better way…….Asserta Health is a healthcare company that’s making this happen.
TPA’s are taking note. However few have adopted the model so far because it’s the complete opposite of 40 years of status quo healthcare financing. Change is difficult for legacy TPAs.
Chances are that if you ever decide to adopt a Lisa Plan strategy you will need to find a willing TPA to partner with and it will probably not be the one you have now.
The LISA Plan is named after one of the founders of Asserta Health. Lisa Behnke is both a nurse and a doctor (a real doctor, not a Phd), and she’s an expert in health care payment. She designed a health plan that addresses the common issues facing both members and providers to enable a better way to navigate the health care system.
The LISA Health Plan offers common sense solutions for healthcare purchasing. The program is a three part strategy that is designed to save money for plan sponsors and plan members.
- The core component is the healthcare concierge-supported Cash Payment program where certain healthcare providers agree to offer services at cash prices, significantly below traditional PPO rates.
- Centers of Excellence provide plan members with quality care, covering most surgical procedures and major treatment protocols. Plan members who elect to receive treatment at designated Centers of Excellence pay no out-of-pocket expenses.
- Plan members who do not elect to take advantage of Cash Payment or Centers of Excellence options may seek medical care through any provider of choice. Benefits for these services include typical plan deductibles, co-pays and co-insurance responsibilities. Plan members may be subject to balance billing if they seek medical care from providers who charge more than the plan allows. In those instances, the plan will attempt to resolve balance billing issues on behalf of members but there is no guarantee those efforts will always be successful.
Contact Asserta Health today at (801) 901-4254 for a free health plan analysis and see if you would be a good fit for The LISA Plan, or reach out to us on our website at: assertahealth.com/#contact
RiskManagers.us is a specialty company in the benefits market that, while not an insurance company, works directly with health entities, medical providers, and businesses to identify and develop cost effective benefits packages, emphasizing transparency and fairness in direct reimbursement compensation methods.
