BEGIN. HealthShare 2000+ Contracts with Providers & Purchasers Integrated Service Providers Management Marketing Provides quality care Makes business.

Slides:



Advertisements
Similar presentations
The Patient-centered Medical Home: Care Coordination Ed Wagner, MD, MPH, MACP MacColl Institute for Healthcare Innovation Group Health Research Institute.
Advertisements

Common Wealth Fund Webinar February 5, 2013
Measuring Progress Toward Accountable Care Aurora Health Care Readiness to Implementation Patrick Falvey, PhD Executive Vice President/ Chief Integration.
An Essential Component of Health Systems Strengthening Presented on: May 23, 2011 Akiko Maeda Health, Nutrition & Population Network The World Bank.
Welcome to the State of Kansas Group Health Insurance Basics Presentation Human Resource Services Spring 2009.
CURRENT SYSTEMS Patients Premium (100% health care dollar) 80% is Filtered Through the Following: Group A – 10%; Group B – 6%; Group C – 20%; Group D –
Navigating the Complex Care System Models and Costs 1.
© 2010 Wittenberg University Springfield, Ohio New Health Care Plan For Retirees Under 65 Effective Oct. 1, 2010.
WaterSoft Conditioning Benefit Plan We Offer Total Benefits Health coverage for you and your family Health coverage for you and your family –Medical.
Medicare and Medicaid EHR Incentive Programs Next Flow Chart to Help Eligible Professionals (EPs) Determine Eligibility for the Medicare and Medicaid Electronic.
Behavioral Health Integration; Experiences of RIPCPC and RIBHN A bit on history and background Development of current model Demonstration of.
MEDICAL HOME 1/2009 Mary Goldman, D.O., President of MAOFP.
ATU SPECIAL OPEN ENROLLMENT Metropolitan Council Benefits.
Tad P. Fisher Executive Vice President Florida Academy of Family Physicians Patient Centered Medical Home A Medicaid Managed Care Alternative.
Alice Taylor BMedSci (Hons) Final Year Student Nottingham Medical School Professor Harold Ellis Medical Student Prize for Surgery 2010.
HSA 171 CAR. Health care Systems 1436/ 6/30  The Means by Which Societies Provide Support for Citizens to Maintain Their Good Health 3.
Copyright © 2008 Delmar Learning. All rights reserved. Chapter 18 Financial Management of the Medical Practice.
Tracey Moorhead President and CEO May 15, 2015 No Disclosures ©AAHCM.
Click here to advance to the next slide.. Chapter 35 Life and Health Insurance Section 35.2 Health Insurance.
Copyright ©2004 Pearson Education, Inc. All rights reserved. Chapter 11 Health and Disability Insurance.
Have you always pictured your future career to be a caring, compassionate, and supportive one? If so, nursing may be the career for you! Registered nurses.
Access to Healthcare Network A membership based, non-profit medical discount plan for under and uninsured Nevada residents.
TRB Plan Governed by the Connecticut Teachers’ Retirement Board (TRB)
Health Insurance HEALTH INSURANCE COVERAGE Hospital insurance pays for most of your charges if you are hospitalized with and illness or injury.
Slides for Class 2 H ADM 545 January 17, Broad model depicting what a Health Care Organizations (HCO) must do to remain financially viable. Hire.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 19: Health Care Economics.
Copay Structure Principles in Practice Copyright © – Academy of Managed Care Pharmacy (AMCP)Slide 1.
United Medical Accountable Care Organization (UMACO)
TRIBAL FOUNDATIONAL PUBLIC HEALTH SERVICES PROJECT May 21, 2015 – Informal Consultation with Tribes Marilyn Scott, Vice Chairperson (Upper Skagit Indian.
How Available is Healthcare Principles of Health Science.
PNHP Plan Principles Access to comprehensive health care is a human right The right to chose and change one’s physician is fundamental Pursuit of corporate.
Lack of Medical Insurance: What can we do…?. Problem: Studies have shown that there is an astounding number of Americans that do not have even the most.
Overview of El Cuero Benefits Health Insurance Options Health, life, dental Savings and Retirement Plans Vacation and Leave Benefits Vacation, sick leave,
Foundation Standard Discuss common methods of payment for healthcare.
International Health Systems: Models for the U.S. Canadian Health Care System in 8 minutes flat!
Copyright ©2004 Pearson Education, Inc. All rights reserved. Chapter 11 Health and Disability Insurance.
Methods of Payment for Healthcare
Coordinating Care Sierra Dulaney Lisa Fassett Morgan Little McKenzie McManus Summer Powell Jackie Richardson.
Financing Health Care United States Healthcare. PRIVATE INSURANCE Pays for all or part of a person’s health care Pays for all or part of a person’s health.
1 1. General Hospital: How long do people stay here? What type of services are provided in this facility? 2. Specialty Hospital: What type of patient does.
NC State Children’s Health Insurance Program  Covers families up to 200% of Federal Poverty Level (FPL)  Benefits package provided by NC Teachers and.
Issues in State-Wide Regional Healthcare Information Organizations Paul Macielak, Esq. New York Health Plan Association June 28, 2005.
 Agreed upon fees paid for coverage of medical benefits for a defined benefit period. Premiums can be paid by employers, unions, employees, or shared.
Medical Coding & Insurance Unit 8 Seminar. CMS Centers for Medicare and Medicaid Services (CMS) Centers for Medicare and Medicaid Services (CMS) Purpose:
Open Enrollment Department of Environmental Quality Second Floor Conference Room Meetings: Monday 10:00 – 11:30 am Thursday 2:00 – 3:30 pm Facilitator:
2 Is the #1 geo-targeted digital media company in the world Operates more than 500 city specific healthcare websites: –i.e.
T RADITIONAL OR PPO H EALTH P LAN W HAT IS A PPO P LAN A Preferred Provider Organization (PPO) is a health plan with an established provider network.
1115 Waiver Proposals California Children’s Services Program.
1 Web Based Decision Support Tools Providing Information to Empower Consumers Consumer Driven Healthcare Summit John Mills Washington, DC September 27,
PPO Plans What You Need To Know Burt Krebs Virginia State Insurance Manager.
County Retiree Health & Life Insurance Benefits County Benefits Office Revised Feb
Practice Transformation Initiative AlignmentCCPNHHNPTN Practice Transformation Network is a 4-year CMS sponsored program that prepares NC and SC providers.
Health Care Providers and Services In this lesson, you will Learn About… The goals of health care. The types of health care providers and facilities. The.
1 Robert Margolis, M.D. CEO, HealthCare Partners February 25, 2010 The Future Design of Accountable, Coordinated Care Organizations.
Health Care Providers and Services In this lesson, you will Learn About… The goals of health care. The types of health care providers and facilities. The.
Methods of Payment for Healthcare
Health Insurance Key Definitions & Frequently Asked Questions
Medicare and Medicaid EHR Incentive Programs
1.03 PP2 Healthcare Finances
Percent of Total Health Care Spending
Methods of Payment for Healthcare
Chart 5.10: RN Employment by Type of Provider, 2015
Alcon Retiree Medical Coverage & Medicare
Health Insurance Premiums & Benefits
Methods of Payment for Healthcare
Accountable care organizations
Daniel Berman DBA/HCA,MSN, RN, FACHE
Health Insurance Premiums & Benefits
Presentation transcript:

BEGIN

HealthShare Contracts with Providers & Purchasers Integrated Service Providers Management Marketing Provides quality care Makes business and patient care decisions Organizes Providers Provides systems & procedures Markets to purchasers Channels patients to providers Administers Plans Designs Healthcare benefits Monitors quality & efficiency Employee Groups Govt. Agencies Businesses, Schools NGOs, Clubs Families & Individuals Physicians Panel Hospitals Other Health Care Services Purchasers CLICK

EBG, VBG & Charitable Trusts EBG, VBG & Charitable Trusts Hospitals & Other Medical Facilities Payments Facilitation Account Medical Services Physicians/Surgeons Physicians/Surgeons Dental, Vision, etc. Dental, Vision, etc. Medical Services Physicians/Surgeons Physicians/Surgeons Dental, Vision, etc. Dental, Vision, etc. Other Providers Re-InsuranceRe-Insurance Other Benefits Out-of-Area Out-of-Area Miscellaneous Miscellaneous Other Benefits Out-of-Area Out-of-Area Miscellaneous Miscellaneous RESERVESRESERVES AdministrationAdministration HEALTHSHARE Medical Trianon ERISA approved Plan Adopted by Employers HEALTHSHARE Medical Trianon ERISA approved Plan Adopted by Employers Escrow Account CONTRACTS CLICK

Radial Chart showing Provider Field of Service Summary of the Categorical Community Survey Each Field of Service would require a full time Provider at each increment charted. A proration of each would be in order at any point between these increments. CLICK 5,000 through 25,000 Subscribers 25,000 through 75,000 Subscribers 75,000 through 325,000 Subscribers 325,000 through 575,000 Subscribers 575,000 through 1,323,600 Subscribers

GROUP TRUSTS COMMUNITY HEALTH BANKING GROUP TRUSTS COMMUNITY HEALTH BANKING C-MEMBERS(Contributing)C-MEMBERS(Contributing) NC-MEMBERS(Non-Contributing)NC-MEMBERS(Non-Contributing) Monthly Contributions Donations and Charitable Funds Direct Deposits EBG & VBG TRUSTS CHARITABLE TRUST HEALTHSHARE COMPUTER PROGRAM EXECUTES DIRECT BANK-TO-BANK ELECTRONIC FUND TRANSFER OVER 100 FIELDS OF SERVICE SPECIALTIES AND FACILITATION MADE AVAILABLE WITHOUT EXTRA CHARGE OVER 100 FIELDS OF SERVICE SPECIALTIES AND FACILITATION MADE AVAILABLE WITHOUT EXTRA CHARGE MEMBERSPATIENTSMEMBERSPATIENTS Pay Membership Due SHARE Workgroups Network Services (Humanitarian)For Learning-Earning- Service SHARE Workgroups Network Services (Humanitarian)For Learning-Earning- Service PARTICIPATING SERVICE PROVIDERS Doctors, Nurses, other Medical & Health Practitioners Hospitals & Healing Centers, Clinics, Labs, Pharmacies, Facilitators & other non-medical professionals PARTICIPATING SERVICE PROVIDERS Doctors, Nurses, other Medical & Health Practitioners Hospitals & Healing Centers, Clinics, Labs, Pharmacies, Facilitators & other non-medical professionals