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There are 5 item(s) tagged with the keyword "Third Party Administrators".

Displaying: 1 - 5 of 5

What more do employer groups expect from their health plan or TPA?

In this busy selling season for TPAs and health plans, we wanted to share an updated eBook that outlines some of what the Advanced Plan for Health is hearing from our TPA, health plan and employer clients related to what employers are really looking for as they’re shopping for benefits.

Here’s an excerpt:

Providing your employer clients with the right mix of services and support boosts your chances of standing out and winning and retaining their business. Fortunately, most self-insured employers want the same thing: healthy employees, positive employee healthcare experiences and reduced costs. Sounds simple enough, but how can you be sure that you are offering the best solutions in today’s strained and ever-changing healthcare environment so that you can continue to differentiate yourself and show value?

Tags: Health Plan, TPA, Third Party Administrators, Employers, eBook, Advanced Plan for Health, Employee Benefits, Employee Benefits
Combating Opioid Addiction with Analytics and Case Management

The current opioid epidemic has shed light on the shortcomings of many wellness programs and the lack of preparedness by case management teams to handle chronic conditions and or patient behavior, such as addictive tendencies or duplicate therapy. But are case management teams solely to blame for lack of effective response to this costly health crisis? The simple answer is, no.

Many case managers do not have access to the data or tools required to employ a compelling and value-driven prevention model. Hence, what we see today is very little accountability or effective case management. What’s needed most is quality data to guide active engagement with patients.

Tags: Opioid, Addiction, Data, Big Data, Predictive Analytics, Account Management, Health Plan, Insurers, Healthcare, Brokers, Payers, Third Party Administrators, TPA, Epidemic, Case Management, Care Management, Care Manager, Wellness Program, Group Benefits, High Cost Claimants, Costs, Chronic Conditions, Behavior, Duplicate Therapy, Rx, Patients, Advanced Plan for Health, Actionable Insight, Health Intelligence, Poindexter, Self-Insured, Health Plan Sponsors, Catastrophic Medical Events, Drug Costs, ER Utilization
Advanced Plan for Health Upgrades Next-Generation Predictive Analytics On Poindexter Population Health Management Platform

Poindexter’s newest release pushes the boundaries of predictive modeling by determining the likelihood of an occurrence of coronary events, neurological events, orthopedic events and chronic kidney disease. In addition, Poindexter now has the ability to predict hospital length of stay and general likelihood of an ER visit for any member of a patient population.  

Third-party Administrators (TPAs) and brokers can leverage Poindexter’s new functionality to better identify at-risk individuals in their customers’ insured population. Employers with self-funded health plans can directly benefit, too.

Tags: Predictive Modeling, Population Health Management, Self-Insured, Employers, Health, Data Science, Actionable Data, Coronary Events, Neurological Events, Third Party Administrators, TPA, Health Insurance Brokers
Chris Galanos - Director, Medical Services

Chris Galanos was Vice President Customer Solutions–Care Management for UMR, the third-party administrator (TPA) unit of UnitedHealthcare. He was responsible for the UMR portfolio of care   management services.

Tags: Bachelors, History, English, Texas Tech University, Harvard University, Harvard School of Public Health, Health, Customer Solutions, Care Management, UMR, Third Party Administrators, TPA, United Healthcare, Management, Sales, Medical Management, Strategic Planning, Product Development
Joy McGee-Cory - President CEBG/Senior Vice President Advanced Plan for Health

Joy McGee-Cory advises health systems, managed care organizations, integrated delivery systems, and physician groups on managed care operations, provider compensation and contracting, regulatory compliance, and accreditation issues.

Tags: Health Systems, Managed Care Organizations, Integrated Delivery Systems, Physician Groups, Managed Care, Provider Compensation, Contracting, Regulatory Compliance, Accreditation, Analysis, Proposal Development, Employer-Sponsored, Health Plan, Provider Network, TPA, Third Party Administrators, Medical, Management, Data, Firms, Policies, Procedures, Utilization Review Agent, URA, Medical Review Organization Certification, National Committee for Quality Assurance, Assessment, NCQA, Policy, Procedure, Payor, Reimbursement, Analysis, CEO, Members, CHIP, Participants, Market, COO, IPA, Capitated, Senior-Vice President, Medical Education, Hospital-Physician, Medical Group, Masters, Business Administration, University of Arkansas, Certified Physician Management Executive, Certified Purchasing Manager, Medical Group Management Association, Texas Association of Preferred Provider Organizations, TAPPO, Nonprofit Health Corporations

Displaying: 1 - 5 of 5