LeadingAge Texas Managed Care Network Development
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MANAGED CARE NETWORK DEVELOPMENT

READY TO SAY YES?
S
ubmit a Letter of Intent to Crystal Laza by Friday, July 12th.

Members of LeadingAge Texas are considering the development of 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 would be governed by a board elected by its members and is only available to LeadingAge Texas members.      

 

To setup a call for more information/questions, please contact: Steve Wermuth, Partner, Strategic Health Care | 614-255-0322; Steve.Wermuth@shcare.net

 


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