Unmatched cost controls for you.
Uncompromised care for your members. Clear decision for both.
Health Choice Preferred currently holds a broad range of commercial (on and off exchange), Medicaid, and Medicare-based fee-for-performance contracts with several of the nation’s largest and most respected health plans. Proactively managing the health and healthcare of our payor partner’s members—especially those with chronic conditions—is a central tenet of the Health Choice Preferred model.
Health Choice Preferred has negotiated a broad range of contract models with our partners—including delegated services, bundled payment programs, shared-risk deals, full-risk deals, transition-to-full-risk deals and total cost of care arrangements—and understands the challenges and opportunities of engaging in value-based payment reform models.
Advantages of the ACO Model
Health Choice Preferred enables physicians to align with other high quality specialists, hospitals and ancillary partners. This model rounds out members’ care teams, improves data information sharing between providers, and minimizes friction in the referral process. This arrangement also helps establish quality of care expectations across providers and improves the ability to monitor and control medical costs.
Benefits for Payors
Health Choice Preferred uses our comprehensive suite of Value-Based Care Solutions to provide our partners with a collaborative and coordinated effort to reduce readmissions, decrease hospital stay lengths, reduce avoidable admissions, and increase patient satisfaction.
Actuarial analyses that drive heightened understanding of member populations.
Protocols to identify and meet quality and cost benchmarks.
Seamless case management programs from admit to discharge, including referral programs, integrated care coordination, and case/disease management programs.
Careful coordination between primary care providers and specialists to prevent readmissions.
Experienced risk adjusters that help providers leverage efficiency.
Coordinated reimbursement methodologies and incentives across providers, single sets of HEDIS and Stars reporting measures, and comprehensive evaluation forms.
Effective pharmacy management, including identification of appropriate generic alternatives and ensuring adherence to maintenance medications.
Marketing partnerships aimed at engaging consumers/prospective members as they select plans and make decisions on care options and expenses.