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Collaborative care
Provider Services Practice
COLLABORATIVE CARE HEALTH PLANS Objectives
A collaborative care plan is a health plan designed in collaboration with • Key stakeholders: member, employer, • Improve community inancial and physical health
Lockton but is owned by the hospital. It’s a direct contracting strategy which provider • Increase sponsors market share
enables a hospital or health system to work with their employed or affiliated • Hospital sponsored plans
providers to assemble a benefit infrastructure to market to the local • Establish meaningful relationships between
employers in defined MSAs. It is does not replace commercial managed care • Sponsor risk arrangements employer and sponsoring provider
offerings but it does solve for the question: What’s next? • Sponsor owns medical management • Reduce duplication of services
• Increase competition
DIRECT CONTRACTING FOR EMPLOYERS • Employer owned direct contract Objectives
Direct contracting is a direct agreement with a specific hospital and
employer. In a direct contract, employers tailor benefits to steer • Focused on employer budget • Lower cost
members to a specific hospital and in exchange, hospitals and providers • Focused on population health • Provider, member, employer accountability
agree to significantly improved price points. Direct contracts, in certain
circumstances, facilitate the development of a risk arrangement — based on • Risk arrangements • Increase member compliance
financial performance or improvement in mutually agreed clinical metrics. • Quality metrics established and measured • Improved member satisfaction
Direct contracting specifically aligns incentives of the hospital and employer.
MANAGED CARE OUTSOURCING
Lockton serves as a resource for managed contracting. The Provider Services
Practice may be engaged in managed care contract review of a previously • Medicaid network development Objectives
negotiated direct contract where the agreement may not be achieving the • Improve market parity
optimal results. Contract language, as well as rate structures are evaluated. • Managed care consulting • Lower managed care contracting cost
The Provider Services Practice may also be engaged by hospitals or • Managed care outsourcing
health plans to assist with managed care contracting activities where • Deliver desired results
staff resources may not be sufficient to meet the timing of contracting
requirements.
Penn Highlands Healthcare — Lockton Total Rewards Practice overview 35 Lockton Companies
Provider Services Practice
COLLABORATIVE CARE HEALTH PLANS Objectives
A collaborative care plan is a health plan designed in collaboration with • Key stakeholders: member, employer, • Improve community inancial and physical health
Lockton but is owned by the hospital. It’s a direct contracting strategy which provider • Increase sponsors market share
enables a hospital or health system to work with their employed or affiliated • Hospital sponsored plans
providers to assemble a benefit infrastructure to market to the local • Establish meaningful relationships between
employers in defined MSAs. It is does not replace commercial managed care • Sponsor risk arrangements employer and sponsoring provider
offerings but it does solve for the question: What’s next? • Sponsor owns medical management • Reduce duplication of services
• Increase competition
DIRECT CONTRACTING FOR EMPLOYERS • Employer owned direct contract Objectives
Direct contracting is a direct agreement with a specific hospital and
employer. In a direct contract, employers tailor benefits to steer • Focused on employer budget • Lower cost
members to a specific hospital and in exchange, hospitals and providers • Focused on population health • Provider, member, employer accountability
agree to significantly improved price points. Direct contracts, in certain
circumstances, facilitate the development of a risk arrangement — based on • Risk arrangements • Increase member compliance
financial performance or improvement in mutually agreed clinical metrics. • Quality metrics established and measured • Improved member satisfaction
Direct contracting specifically aligns incentives of the hospital and employer.
MANAGED CARE OUTSOURCING
Lockton serves as a resource for managed contracting. The Provider Services
Practice may be engaged in managed care contract review of a previously • Medicaid network development Objectives
negotiated direct contract where the agreement may not be achieving the • Improve market parity
optimal results. Contract language, as well as rate structures are evaluated. • Managed care consulting • Lower managed care contracting cost
The Provider Services Practice may also be engaged by hospitals or • Managed care outsourcing
health plans to assist with managed care contracting activities where • Deliver desired results
staff resources may not be sufficient to meet the timing of contracting
requirements.
Penn Highlands Healthcare — Lockton Total Rewards Practice overview 35 Lockton Companies
