/ en Fri, 25 Apr 2025 20:17:49 -0500 Wed, 18 Oct 23 10:38:14 -0500 /education-events/provider-led-health-plans-strategic-leadership-group-0 Wed, 18 Oct 2023 10:38:14 -0500 Provider-Sponsored Health Plans (PSHPs) /education-events/provider-led-health-plans-strategic-leadership-group Wed, 18 Oct 2023 10:13:49 -0500 Provider-Sponsored Health Plans (PSHPs) /aha-center-health-innovation-market-scan/2022-07-19-cleveland-clinic-adds-two-centers-excellence <div class="container"> <div class="row"> <div class="col-md-8"> <p><img alt="Cleveland Clinic Adds Two Centers of Excellence to Its Direct-to-Employer Plans. Two physicians in surgical gowns, masks, and eye protection examine X-rays of a patient's knee." data-entity-type="file" data-entity-uuid="da44ed79-3843-4dc6-920a-2fe096db0774" src="/sites/default/files/inline-images/Cleveland-Clinic-Adds-Two-Centers-of-Excellence-to-Its-Direct-to-Employer-Plans.jpg" width="1320" height="880"></p> <p>Direct-to-employer health care programs continue to develop as a model to streamline care delivery and reduce costs. Twelve years after rolling out its initial direct-to-employer products, <a href="https://newsroom.clevelandclinic.org/2022/07/07/cleveland-clinic-expands-centers-of-excellence-offerings-for-employers/" target="_blank" title="Cleveland Clinic Newsroom: Cleveland Clinic Expands Centers of Excellence Offerings for Employers">Cleveland Clinic</a> recently launched a <a href="https://my.clevelandclinic.org/departments/employer-healthcare-solutions/how-we-can-help/musculoskeletal-center-of-excellence" target="_blank" title="Cleveland Clinic: Musculoskeletal Center of Excellence">Musculoskeletal Center of Excellence</a> and a <a href="https://my.clevelandclinic.org/departments/employer-healthcare-solutions/how-we-can-help/bariatric-center-of-excellence" target="_blank" title="Cleveland Clinic: Bariatric Center of Excellence">Bariatric Center of Excellence</a>.</p> <p>As in previous programs, the new options are designed to help employers manage costs while providing employees and their covered dependents with access to Cleveland Clinic in Ohio. The new offerings also will make equitable health care easy to access, making Cleveland Clinic a preferred destination for these services.</p> <p>Under the center of excellence programs, a Cleveland Clinic surgeon conducts a thorough medical record review. In some cases, the review can avoid surgical procedures — benefiting the patient and lowering costs to the employer. Cleveland Clinic’s group practice physician model ensures that there is no incentive to provide surgical intervention. The organization notes that only one in eight patients at its <a href="https://my.clevelandclinic.org/departments/neurological/outcomes/888-center-for-spine-health" target="_blank" title="Cleveland Clinic: Center for Spine Health">Center for Spine Health</a> pursues a surgical pathway in the first year.</p> <p>In addition, depending on the coverage, Cleveland Clinic assists in orchestrating travel arrangements and provides concierge services for program patients. Other benefits include patient navigators who assist in coordinating with home providers and virtual care options.</p> <p>The Musculoskeletal Center of Excellence also is supported by <a href="https://my.clevelandclinic.org/departments/orthopaedics-rheumatology" target="_blank" title="Cleveland Clinic: Orthopaedic & Rheumatologic Institute">Cleveland Clinic’s Orthopaedic & Rheumatologic Institute</a>, whose specialists in Ohio and Florida perform more than 8,000 hip- and knee-replacement surgeries annually with outcomes consistently better than the national average, the organization reports.</p> <p>Meanwhile, Cleveland Clinic’s bariatric surgeons perform more than 95% of procedures with minimally invasive laparoscopic techniques, improving patients’ healing and recovery times.</p> </div> <div class="col-md-4"> <p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img alt="AHA Center for Health Innovation logo" data-entity- data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" type="file" class="align-center"></a></p> <a href="/center/form/innovation-subscription"><img alt data-entity-type data-entity-uuid src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png"></a></div> </div> </div> .field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 19 Jul 2022 06:00:00 -0500 Provider-Sponsored Health Plans (PSHPs) <p>The ºÚÁÏÕýÄÜÁ¿ Association looks forward to working with CMS on implementing the good faith estimates and advanced explanation of benefits (EOB) required by the No Surprises Act. We are very supportive of efforts, such as these, to better help patients access the information they need as they prepare for their care, including price information. View the entire letter below.</p> Fri, 04 Jun 2021 14:26:33 -0500 Provider-Sponsored Health Plans (PSHPs) /aha-center-health-innovation-market-scan/2021-05-25-jpmorgan-chase-launches-new-unit-improve-care <div class="container"> <div class="row"> <div class="col-md-8"> <p><img alt="JPMorgan Chase Launches New Unit to Improve Care Quality for Employees. A JPMorgan Chase sign in front of a skyscraper." data-entity-type="file" data-entity-uuid="1893686a-7f37-4659-a04e-0c075ec85a62" src="/sites/default/files/inline-images/ms_052321_item3_JP_MorganChase_190_1919013.jpg" width="190" height="127" class="align-right">Just months after ending its Haven collaborative with Amazon and Berkshire Hathaway to cut employee health care costs and improve quality, JPMorgan Chase is banking on a new model. It plans to invest up to $250 million in a new venture — <a href="https://www.businesswire.com/news/home/20210520005664/en/JPMorgan-Chase-Launches-Morgan-Health" target="_blank">Morgan Health</a> — to improve outcomes and promote health equity.</p> <p>The company plans to collaborate with leading health care organizations and ultimately to develop models for other employers looking to improve health care. Morgan Health also will look for ways to improve behavioral health and management of specific diseases, and tackle disparities that have raised costs and led to health care inequities.</p> <p>Dan Mendelson, a former Clinton White House health official who also founded the consultancy Avalere Health, and Peter Scher, JPMorgan Chase vice chair, will head Morgan Health. In a company statement and media interviews just after the announcement, Mendelson said it will take time to generate results and declined to provide specific goals, but he stressed that the new venture will have a longer life span than Haven.</p> <p>Like JPMorgan Chase, Amazon took steps after the closing of Haven to reduce its employee health care costs, improve quality and simplify access. The Amazon Care telehealth program, which originally was offered to employees in select locations, is now offered to all Amazon staff and their dependents and also is being marketed to other businesses.</p> </div> <div class="col-md-4"> <p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img alt="AHA Center for Health Innovation logo" data-entity- data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" type="file" class="align-center"></a></p> <a href="/center/form/innovation-subscription"><img alt data-entity-type data-entity-uuid src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png"></a></div> </div> </div> .field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } Tue, 25 May 2021 06:15:00 -0500 Provider-Sponsored Health Plans (PSHPs) /lettercomment/2021-02-04-aha-expresses-concerns-regarding-series-unitedhealthcare-health-plan <p><span><span>AHA expresses deep concerns regarding a series of UnitedHealthcare health plan coverage policies to the Centers for Medicare & Medicaid Services. These new restrictions will create significant barriers to access to necessary diagnostic and specialty pharmacy services for tens of millions of health plan enrollees. </span><span><span>Read the full letter below under Key Resources.</span></span></span></p> Thu, 04 Feb 2021 11:48:23 -0600 Provider-Sponsored Health Plans (PSHPs) /news/headline/2019-11-14-survey-updating-health-plan-directories-costs-practices-nearly-3b-year <p>Physician practices spend an estimated $2.76 billion a year updating provider directory information for health plans, according to a <a href="https://www.caqh.org/about/press-release/caqh-survey-maintaining-provider-directories-costs-us-physician-practices-276">survey</a> released yesterday by CAQH. The average physician practice must submit information for 20 health plan contracts in varying formats and on different schedules for each plan, the survey found. CAQH estimates that using a single channel to update directory information could save at least $1.1 billion annually. "Our nation's fragmented approach to maintaining provider directories is not only a burden on physician practices, it may be undermining the accuracy of the data," said April Todd, a senior vice president for CAQH, an alliance that works to streamline health care business processes. "Health plans rely on the information providers give them. If we minimize the requests that drive provider burden, we can improve the accuracy of the data."</p> Thu, 14 Nov 2019 15:00:14 -0600 Provider-Sponsored Health Plans (PSHPs) /advocacy/providers-with-health-plans <p>Some provider-owned health plans cover just one market segment (e.g., Medicaid managed care) and other plans offer a full portfolio of products for the public and commercial sectors. There are increasing examples of health care systems and hospitals partnering with provider and commercial health plans to offer health insurance products in local markets.</p> <p>The AHA ensures that all members’ perspectives and needs, including those of members with health plans, are heard and addressed in national health policy development, legislative and regulatory debates, judicial matters, and with the media and consumers.</p> <p>The AHA has launched the Provider-Sponsored Health Plan Strategic Leadership Group to help develop the AHA’s policy and advocacy agenda specific to this segment of our membership. The Leadership Group also advises the AHA on the products and tools that can assist our members in sharing and developing best practices for business and strategic issues. Read on for valuable information in related resources below. </p> Thu, 09 Nov 2017 11:00:44 -0600 Provider-Sponsored Health Plans (PSHPs) /guidesreports/2015-12-04-performance-provider-sponsored-health-plans <p>In this study, the research team sought to compare the performance of provider-sponsored health plans (PSHPs) versus the three largest nonprovider- sponsored health plans (NPSHPs) in their markets, based on publicly reported data for the period 2011-2013. The findings indicate that the performance of all health plans—PSHPs and NPSHPs—varieswidely and changes frequently from year to year.</p> Fri, 04 Dec 2015 00:00:00 -0600 Provider-Sponsored Health Plans (PSHPs)