LeadingCare Network Texas
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LeadingCare Network Texas


Members of LeadingAge Texas are developing an organization whose mission will be to maximize the health and well-being of seniors in its member communities through innovative, cost-effective care management practices and quality improvement activities through contracting relationships with managed care plans. LeadingAge Texas members participating in the network will have opportunities to secure value-based and pay-for performance contracts enhancing their reimbursement through these quality-based programs. The network is governed by a board elected by its members and is only available to LeadingAge Texas members.      

  


WHY SHOULD I JOIN?

  • Over 35% of seniors in Texas get their health care through a Medicare Advantage Plan and it continues to grow!
  • A network can get you access to payors you struggle to get previously.
  • Increases in reimbursement with payors you are already under contract with (other LeadingAge networks have experienced increases in contracts from $25/bed day, pay-for-performance contracts, four level contracts with rates higher than RUGS)
  • Reduced administrative burden. Contract negotiation, contract management, claims issues, credentialing, etc. As a member of the network, you focus on serving your residents. Claim payment problems, prior authorization issues, credentialing with payors are all done for you by the network.
  • Greater visibility and attention by government, Medicare Advantage and commercial payors. We are their priority.
  • Ability to identify key quality measures, collect data on those measures, aggregate information and present it in a meaningful way to payors and partners.
    LeadingAge members in four other states who have formed a managed care network on average pay between $5,000 - $7,000 per year to be in the network. 

HOW MUCH WILL I PAY?

LeadingAge members in four other states who have formed a managed care network on average pay between $5,000 - $7,000 per year to be in the network.

WHAT'S NEXT?

A group of LeadingAge Texas members will be meeting to develop the structure of the network.  If you are interested in being involved, please contact Crystal Laza crystal@leadingagetexas.org

Download a one-pager to share with your team


Questions?

Crystal Laza, VP
LeadingAge Texas
crystal@leadingagetexas.org
512.467.2242 x 102

George Linial, President & CEO
LeadingAge Texas
george@leadingagetexas.org
512.467.2242 x 103

LeadingAge Texas MCO Network Development - Consultant Contact:

Steve Wermuth, Partner
Strategic Health Care
614-255-0322
Steve.Wermuth@shcare.net


VIEW THE MANAGED CARE NETWORK DEVELOPMENT PRESENTATION

RECORDED WEBINAR - April 9, 2019

Frequently Asked Questions & Return on Investment

Map: % of MA Participation by Region

Medicare Advantage Market Penetration and Payors by County

OASN Dashboard Sample